Pathophysiology of Acute Abdominal Disease with Intestinal Obstruction

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Patients with a prior history of abdominal surgery, particularly in the pelvic region, are at a higher risk of developing intraabdominal adhesions due to:

A decrease in inflammatory response in the abdominal cavity

Increased peristalsis in the bowel leading to adhesions formation

Chronic inflammation from previous surgeries (correct)

Genetic predisposition to bowel adhesions

Which factor increases the risk of developing hypotonic bowel in patients?

Regular physical activity

Consuming a high-fiber diet

Taking antibiotics

Being on bed rest (correct)

How do bowel obstruction, strangulation, and perforation lead to hypovolemia?

By reducing electrolyte balance

By increasing fluid intake

By enhancing intravascular volume

Through vomiting and diarrhea causing fluid losses (correct)

What is the main cause of sepsis in cases of perforated bowel?

Inflammatory response to enterotoxins and bacteria Signup and view all the answers

How does multisystem organ dysfunction syndrome primarily contribute to increased mortality?

By initiating an inflammatory response Signup and view all the answers

What physiologic concern is associated with toxic megacolon?

Systemic absorption of bacterial endotoxins leading to mucosal inflammation Signup and view all the answers

What are the typical signs and symptoms of bowel obstruction?

Pain, absence of bowel sounds, and leukocytosis Signup and view all the answers

What physiologic manifestation is associated with bowel perforation?

Hypersecretion of fluid enhanced by prostaglandin release Signup and view all the answers

Why is toxic megacolon more likely to occur in critically ill patients undergoing aggressive antibiotic therapy?

The antibiotic therapy promotes bacterial overgrowth Signup and view all the answers

What are the implications of aggressive resuscitation in cases of toxic megacolon?

Increased risk of sepsis due to enhanced prostaglandin release Signup and view all the answers

Why is it important to consider preoperative data and preexisting comorbidities for fluid management in patients undergoing bowel resection surgery?

To estimate the magnitude of fluid deficit and select appropriate resuscitative fluid Signup and view all the answers

What consequences can occur due to fluid losses caused by vomiting and diarrhea in patients undergoing bowel resection surgery?

Electrolyte imbalances requiring replacement Signup and view all the answers

How does bowel obstruction contribute to the failure in barrier function during bowel resection surgery?

By causing third-space loss into the interstitium within the intestinal wall Signup and view all the answers

What is a potential benefit of administering oral antibiotics in combination with mechanical bowel preparation (MBP) for patients undergoing elective intraabdominal surgery?

Lower rates of surgical site infections Signup and view all the answers

What physiological consequences may malnourished or medically compromised patients face as a result of preoperative bowel preparation for surgery?

Tachycardia and hypotension Signup and view all the answers

Which modality may be employed effectively as a primary modality or as a supplement to an epidural technique for postoperative analgesia after laparotomy?

Patient-controlled analgesia (PCA) Signup and view all the answers

What may effectively decrease postoperative opioid requirements and has shown analgesic properties in patients undergoing laparotomy?

Combination therapy with NSAIDs and opiates Signup and view all the answers

What approach, if instituted, may significantly decrease the degree of postoperative pain after laparotomy?

Laparoscopic approach Signup and view all the answers

Which medication, when administered in low IV doses, effectively augments the effect of opioids for postoperative pain management?

Ketamine Signup and view all the answers

What technique anesthetizes sensory nerves of the anterior abdominal wall and can be utilized for postoperative analgesia after laparotomy?

Transverse abdominis plane block Signup and view all the answers