Term
| most common cause of small bowel obstruction: |
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Definition
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Term
| 2nd leading cause of small bowel obstruction: |
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Definition
| malignant tumors or strictures |
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Term
| 3rd leading cause for small bowel obstruction: |
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Definition
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Term
| what is the hallmark for small bowel obstruction: |
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Definition
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Term
| occurs in 25% of small bowel obstructions, assoc w hernia, volvulus, intussusceptions & can progress to infarction and gangreen wn 6hrs: |
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Definition
| strangulating small bowel obstruction |
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Term
| in a large bowel obstruction, strangulation is rare except in: |
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Definition
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Term
| risk for ___________ is high if the cecum is dilated to >13cm |
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Definition
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Term
| 5 causes of colonic obstruction: |
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Definition
1. tumors
2. diverticulitis
3. volvulus
4. fecal impoaction
5. Hirschsprung's dz |
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Term
| colonic tumors are usually located in the: |
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Definition
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Term
| diverticuli are usually located in the: |
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Definition
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Term
| colonic volvulus is usually located: |
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Definition
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Term
| causes of duodenal obstruction in adults: |
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Definition
| cancer of duodenum or head of pancreas & ulcer dz |
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Term
| 4 sx of bowel obstruction: |
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Definition
1. abdominal distension
2. cramping
3. vomiting
4. obstipation (later onset) |
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Term
| clinical presentation of small bowel obstruction: |
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Definition
| sx shortly after onset, w pain centered around the umbilicus or epigastric & vomiting |
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Term
| changes in bowel habits of those with complete obstruction of the small bowel vs those with incomplete obstruction of the small bowel: |
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Definition
complete: obstipation
incomplete: diarrhea (water over the dam) |
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Term
| sx associated with strangulation: |
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Definition
| severe steady pain of obstruction |
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Term
| how are sx of large bowel obstruction different than small bowel obstruction? |
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Definition
| large bowel usually causes milder sx that develop more gradually, lower abd (hypogastric)cramps w obstipation (severe constipation) |
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Term
| often has an abrupt onset, pain is continuous, sometimes with waves of superumposed colicky pain: |
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Definition
| Volvulus (bowel has twisted on itself) |
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Term
| upon rectal exam, suggests obstruction: |
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Definition
| empty rectal vault, but presence of stool does not RO obstruction |
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Term
| in small bowel obstruction the abdomen is not tender in the absence of: |
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Definition
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Term
| upon physical exam: the absence of bowel sounds suggests: |
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Definition
| obstruction, strangulation, infarction abd will be tender |
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Term
| 2 signs the indicate late simple obstruction or strangulation of the bowel: |
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Definition
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Term
| presentation of obstructed large bowel: |
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Definition
1. distended abd w loud borborygmi (growling)
2. no tenderness to palpation
3. empty rectum
4. hypogastric cramps |
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Term
| small bowel diameter of __, large bowel diameter of __, or a cecal diameter of __ suggests a complete obstruction and possibly bowel wall necrosis: |
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Definition
small bowel: 6cm
large bowel: 12cm
cecal: 15cm |
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Term
| imaging test that is usually adequate to dx obstruction: |
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Definition
| supine & upright abd x-rays |
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Term
| x-ray for bowel obstruction shows: |
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Definition
1. ladderlike series of distended small bowel loops
2. air fluid levels
3. distension of colon proximal to obstruction |
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Term
| x-ray finding that suggests gangreen of the bowel: |
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Definition
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Term
| distended bowel loops and fluid levels may be absent in the obstruction of: |
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Definition
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Term
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Definition
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Term
| 2 imaging studies for suspected volvulus: |
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Definition
| 1. sigmoidoscopy 2. barium enema |
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Term
| contast enema shows "bird beak" deformity: |
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Definition
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Term
| elevated WBC and lactate may indicate: |
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Definition
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Term
| about __% of small bowel obstructions reolve w nonoperative tx: |
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Definition
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Term
| what% of complete small bowel obstructions require surgery: |
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Definition
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Term
| tx for suspected partial obstruction or paralytic ileus: |
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Definition
1. NG decompression
2. IV fluids
3. observation wo surgical intervention |
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Term
| obstructed patients should be watched for no more than __ before being brought to surgery. |
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Definition
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