Intestinal Obstruction - General Surgery Lecture
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Questions and Answers

What is a potential complication of intestinal obstruction related to the body's fluid balance?

  • Dehydration (correct)
  • Cardiac arrest
  • Venous thrombosis
  • Pulmonary edema
  • Which electrolyte disturbance could potentially arise from an intestinal obstruction?

  • Hypercalcaemia
  • Hypokalaemia (correct)
  • Hyponatraemia
  • Hypomagnesaemia
  • Which investigation would be most appropriate to assess for bowel ischemia in a patient suspected of having intestinal obstruction?

  • CT Abdo-Pelv. (IV/ Oral +/- Rectal Contrast) (correct)
  • CBC (Complete Blood Count)
  • Electrolyte analysis
  • Abdominal X-ray (Er./Sup.)
  • Which method is used to initially visualize the bowel in cases of suspected intestinal obstruction?

    <p>Abdominal X-ray (Er./Sup.)</p> Signup and view all the answers

    In the management of intestinal obstruction, what is the primary focus of initial investigations?

    <p>Assessment of dehydration and electrolyte levels</p> Signup and view all the answers

    Which of the following is NOT a type of intestinal obstruction?

    <p>Inflammatory obstruction</p> Signup and view all the answers

    What is a common mechanical cause of small bowel obstruction?

    <p>Adhesions</p> Signup and view all the answers

    Which of the following is classified as a benign type of intestinal obstruction?

    <p>Intussusception</p> Signup and view all the answers

    What type of obstruction involves the impairment of passage due to dysfunction of bowel motility?

    <p>Obstructive ileus</p> Signup and view all the answers

    Which condition is associated with large bowel obstruction and involves twisting of the bowel?

    <p>Volvulus</p> Signup and view all the answers

    In the pathophysiology of intestinal obstruction, what is a consequence of intestinal distention?

    <p>Decreased intestinal blood flow</p> Signup and view all the answers

    Which of the following is a likely functional cause of small bowel obstruction?

    <p>Post-operative changes</p> Signup and view all the answers

    Which option describes a possible complication of intestinal obstruction?

    <p>Bacterial overgrowth</p> Signup and view all the answers

    Which type of obstruction is characterized by complete loss of bowel content passage?

    <p>Complete obstruction</p> Signup and view all the answers

    What should be closely monitored in a patient with large bowel obstruction?

    <p>Intestinal blood flow</p> Signup and view all the answers

    Which of the following conditions is more likely to cause functional large bowel obstruction?

    <p>Ogilvie syndrome</p> Signup and view all the answers

    What is the primary diagnostic hallmark of intestinal obstruction?

    <p>Vomiting</p> Signup and view all the answers

    What is a common surgical complication of untreated intestinal obstruction?

    <p>Perforation</p> Signup and view all the answers

    Study Notes

    Definition of Intestinal Obstruction

    • Intestinal obstruction occurs when there is an impairment in the passage of intestinal contents, leading to a lack of normal propulsion and movement through the gastrointestinal (GI) tract.

    Types of Intestinal Obstruction

    • Small Bowel vs. Large Bowel
    • Acute vs. Chronic
    • Benign vs. Malignant
    • Mechanical vs. Functional (ileus)
    • Complete vs. Partial obstruction

    Etiology of Small Bowel Obstruction

    • Mechanical Causes
      • Adhesions from previous surgeries
      • Hernias
      • Intussusception
      • Mickle’s diverticulum
      • Tumors in the small bowel
      • Peritoneal carcinomatosis
    • Functional Causes
      • Post-operative ileus
      • Medications affecting gut motility
      • Electrolyte disturbances
      • Inflammatory conditions

    Etiology of Large Bowel Obstruction

    • Mechanical Causes
      • Cancer
      • Diverticulitis
      • Volvulus (twisting of bowel)
    • Functional Causes
      • Ogilvie syndrome (acute colonic pseudo-obstruction)

    Pathophysiology

    • Accumulation of intestinal gas and fluid
    • Bacterial overgrowth in the affected bowel segment
    • Compromised intestinal blood flow
    • Increased intestinal distention and pressure
    • Decreased intestinal motility leading to further complications

    Clinical Presentation

    • Key symptoms:
      • Vomiting
      • Abdominal pain
      • Abdominal distension
      • Constipation (severe cases leading to obstipation)

    Complications of Intestinal Obstruction

    • Dehydration due to fluid loss
    • Electrolyte imbalances
    • Bowel ischemia due to interrupted blood supply
    • Risk of perforation, leading to peritonitis

    Management Strategies

    • Investigations
      • Laboratory tests: Complete blood count (CBC), Urea & Electrolytes (U&E)
      • Imaging studies:
        • Abdominal X-ray (erect/supine)
        • CT abdomen/pelvis with contrast to identify transition zone, masses, ischemia, or fluid accumulation

    Summary

    • Intestinal obstruction can be classified based on location, duration, and nature, with varying etiologies emphasizing the need for comprehensive diagnostic and management strategies to prevent complications.

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    Quiz Team

    Description

    This quiz covers the essential aspects of intestinal obstruction, including its definition, types, and etiology. Designed for 4th-year general surgery students, it aims to enhance understanding and retention of critical concepts in surgical education.

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