INTESTINAL OBSTRUCTION

 Occurs when a blockage prevents the normal flow of intestinal contents through the
intestinal tract.

(Normal Functioning Intestines)

MECHANICAL OBSTRUCTION

 Blockage occurs without vascular compromise. Ingested fluid and food, digestive
secretions, and gas accumulate above the obstruction.

1. SMALL BOWEL OBSTRUCTION

 Is a partial or complete or complete blockage of the small intestine.

 Causes water matter and gases to build up in the portion above the blockage.
 Interfere with the absorption of nutrients and fluids.
ETIOLOGY:
Small-bowel obstruction (SBO) is caused by a variety of pathologic processes. The most
common cause of SBO in developed countries is intra-abdominal adhesions, accounting
for approximately 65% to 75% of cases, followed by hernias, Crohn disease, malignancy,
and volvulus.

PATHOPYSIOLOGY:
In simple mechanical obstruction, blockage occurs without vascular compromise.
Ingested fluid and food, digestive secretions, and gas accumulate above the obstruction.
The proximal bowel distends, and the distal segment collapses. The normal secretory and
absorptive functions of the mucosa are depressed, and the bowel wall becomes edematous
and congested. Severe intestinal distention is self-perpetuating and progressive,
intensifying the peristaltic and secretory derangements and increasing the risks of
dehydration and progression to strangulating obstruction.
 CAUSES OF SMALL BOWEL OBSTRUCTION
 Small Bowel Obstruction can occur in people of all ages.
 The following are the common causes and the risk factors:

 ADHESIONS – these are bands of scar tissue that may form after
abdominal or pelvic surgery.

 HERNIAS – the segments of the intestine may break through a weakened

section of the abdominal wall.

 INFLAMMATORY BOWEL DISORDERS – can damage parts of the

small intestine

 MALIGNANT (CANCEROUS) TUMORS – cancer accounts for a small

percentage of small bowel obstructions

SYMPTOMS of SMALL BOWEL OBSTRUCTION

 ABDOMINAL (STOMACH) CRAMPS and PAIN
 BLOATING
 VOMITING
  NAUSEA
 DEHYDRATION
 MALAISE
 LACK OF APPETITE
 SEVERE CONSTIPATION

DIAGNOSIS & TESTS

 Medical history
 Physical examination
 Blood tests

 Abdominal X-rays
 Computed tomography (CT scan):

MANAGEMENT & TREATMENT

 HOSPILAIZATION: Treatment includes intravenous (in the vein) fluids, bowel rest
with nothing to eat (NPO), and, sometimes, bowel decompression through a
nasogastric tube (a tube that is inserted into the nose and goes directly to the
stomach).
  ANTI-EMETICS: Medications may be required to relieve nausea and vomiting.
 SURGERY: If the small intestine is completely blocked, surgery may be needed. The
goals of surgery are to identify and treat the causes of bowel obstruction.

CONNECTION TO THE SCENARIO:

SYMPTOMS PRESENT TO THE PATIENT:

 Patient reported feeling NAUSEATED

 Patient complained of STOMACH UPSET

LARGE BOWEL OBSTRUCTION

 Is a medical emergency.
 It occurs when a tumor, scar tissue, or something else blocks the large intestine.
 Gas and stool build-up, and the intestine may rupture.
 (8 sites possible of large bowel obstruction)

ETIOLOGY:
The most common causes of large-bowel obstructions (LBO) are colon carcinoma and
volvulus. Approximately 60% of mechanical LBOs are caused by malignancies, 20% are
caused by diverticular disease, and 5% are the result of colonic volvulus.
PATHOPYSIOLOGY:

The prevalence of mechanical large-bowel obstruction (LBO) increases with age, as does that
of its main causes, colon cancer and diverticulitis. Sigmoid volvulus and cecal volvulus are
also potential causes of this disorder. 
Mechanical LBO causes bowel dilatation above the obstruction, which in turn, causes
mucosal edema and impaired venous and arterial blood flow to the bowel. Bowel edema and
ischemia increase the mucosal permeability of the bowel, which can lead to bacterial
translocation, systemic toxicity, dehydration, and electrolyte abnormalities. Bowel ischemia
can lead to perforation, fecal spoilage of the peritoneal cavity, and dead bowel.

CAUSES OF LARGE BOWEL OBSTRUCTION:

 People of all ages and genders can get large bowel obstructions.

 Some infants are born with a birth defect called malrotation

 In children younger than three, a disorder called intussusception may cause
blockages.
  Up to half of adults who develop a large bowel obstruction have colorectal
(colon) cancer.

SYMPTOMS OF LARGE BOWEL OBSTRUCTION:

 Abdominal pain, cramping or bloating.

 Diarrhea.
 Inability to pass gas or poop (constipation).
 Loss of appetite.
 Nausea and vomiting.

 Fever
 Blood in stool 
 Green or yellow-green vomit.
 Lethargy
 Swollen, firm belly.
DIAGNOSIS & TESTS:

PHYSICAL EXAM: Your healthcare provider check for a swollen abdomen or masses.
Your healthcare provider will use a stethoscope to listen to the intestines.

OTHER TESTS:

 Blood tests: A blood test checks for signs of infection and dehydration.

 Abdominal X-rays: show a bowel blockage’s location
 CT scan: the imaging procedure that provides mor detailed photos than x-rays.
 Barium enema-X-ray: is a lower gastrointestinal (IG) exam

MANAGEMENT & TREATMENT:

Treatments for large bowel obstructions include:

 IV fluid
replacement: 
 Medications:

 Nasogastric tube:
 Barium enema: 

 Surgery: 
CONNECTION TO THE SCENARIO:

SYMPTOMS PRESENT TO THE PATIENT:

 Patient reported feeling NAUSEATED

 Patient reported passage of soft stool for three times with slightly blood
appearance
 Patient complained of stomach upset

REFERENCES:
https://www.mayoclinic.org/diseases-conditions/intestinal-obstruction/symptoms-
causes/syc-20351460
https://emedicine.medscape.com/article/774140-overview#a1
https://www.msdmanuals.com/professional/gastrointestinal-disorders/acute-
abdomen-and-surgical-gastroenterology/intestinal-obstruction
https://jamanetwork.com/journals/jama/fullarticle/2681748
https://emedicine.medscape.com/article/774045-overview#a1
https://my.clevelandclinic.org/health/diseases/15287-large-bowel-intestinal-
obstruction#symptoms-and-causes