PATHOPHYSIOLOGY (Intestinal Obstruction)

PATHOPHYSIOLOGY (Intestinal Obstruction) Intestinal obstruction develops in three forms. In a simple intestinal obstruction, blockage prevents intestinal contents from passing, with no other complications. In strangulated intestinal obstruction, blood supply to par of all of the obstructed section is cut off, in addition to blockage of the lumen. Lastly, both ends of a bowel section are occluded, isolating it from the rest of the intestine in a closed-loop intestinal obstruction. The physiologic effects are similar in all three forms of obstruction; when intestinal obstruction occurs, fluid, air, and gas collect near the site. Peristalsis increases temporarily as the bowel tries to force its contents through the obstruction, injuring intestinal mucosa and causing distention at and above the site of the obstruction. Distention blocks the flow of venous blood and halts normal absorptive processes; as a result, the bowel begins to secrete water, sodium, and potassium into the fluid pooled in the lumen. Obstruction in the small intestine results in metabolic alkalosis from dehydration and loss of gastric hydrochloric acid; lower bowel obstruction causes slower dehydration and loss of intestinal alkaline fluid, resulting in metabolic acidosis. Ultimately, intestinal obstruction may lead to ischemia, necrosis, and death.