III. The Patient and his Illness Pathophysiology Intestinal Obstruction Predisposing Factors: Congenital/acquired muscle weakness.

ss. Being a member of a high risk ethnic group (Hispanic, Black, Native American, or Asian). Age: present at birth and also between 15 35 y/o. Gender: both males and females. Traumatic injuries from blunt pressure.

Precipitating Factors: Heavy lifting Obesity Pregnancy Coughing Straining

Hernia protrusion of intestine through a weakened area in the abdominal muscle or wall; intestinal flow may be completely obstructed. Blood flow to the area may be obstructed.

Incarcerated hernia

Strangulated hernia

Inguinal hernia

Femoral hernia

Mechanical Obstruction Hyperactive bowel sounds (proximal Visible peristaltic waves Borborygmi Incomplete contraction of proximal intestine Severe colicky abdominal pain A B C Abdominal distension and Distension of intestine Persistent vomiting Gases and fluids accumulate in the area Presence of obstruction due to hernia to the obstruction), resulting to metallic tinkling or ringing sound. Bacterial Activity

III. The Patient and his Illness Pathophysiology

A Increase intraluminal pressure Increase secretions into the intestine Compression of veins Increase venous pressure Decreased absorption Edema of the intestine Dehydration

B Loss of fluids and electrolytes such as sodium, potassium and chloride

Hyponatremia Metabolic Alkalosis

Hypokalemia

If untreated immediately, it can lead to: Shock DEATH

Decrease arterial blood supply Ischemia, Anoxia

Compression of mesenteric arteries of terminal branches

Necrosis Gangrenous intestinal wall

Perforation of necrotic segments

Bacteria or toxins will lead into:

Peritoneal cavity Peritonitis

Blood Supply Bacteremia Septicemia

Cessation of Decreased bowel sounds peristalsis

DEATH

Systemic infection

Severe infection

If untreated immediately, it can lead to: