Category Archives: Gastrointestinal

Small Bowel Obstruction

Quick Hit:

  • Etiology:
    • Most common = Adhesions (post-abdominal surgery)
    • Other causes = hernia, malignancy, intraluminal stricture, intussusception, foreign body, duodenal hematoma
  • Symptoms
    • colicky/paroxysmal abd pain w/ episodic, hyperactive bowel sounds, diffuse abd tenderness, bilious vomit
    • failure to pass stool or flatus = signs of complete bowel obstruction
  • Diagnosis: dilated loops on x-ray, dilated fluid filled loops (air-fluid levels) on CT Abdomen
  • Management:
    • IV fluid resuscitation w/ electrolyte repletion
    • Complete obstruction, or signs of peritonitis = surgical emergency
    • Partial obstruction: non-operative management (NG tube decompression, close observation)
  • Complications: strangulation
    • Signs of strangulation = metabolic acidosis from lactic acidosis secondary to ischemic necrosis caused by strangulation

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