Intestinal Obstruction

Introduction:

Intestinal obstruction refers to a blockage that prevents the normal flow of digested food, fluids, and gas through the intestines. It can occur in the small intestine (small bowel obstruction) or the large intestine (large bowel obstruction). Intestinal obstruction can be a medical emergency requiring prompt diagnosis and treatment to prevent serious complications such as bowel perforation and ischemia.

Understanding Intestinal Obstruction:

Intestinal obstruction can result from various causes, including mechanical blockages, functional issues, or a combination of both. Mechanical obstructions occur when there is a physical barrier that obstructs the passage of intestinal contents, such as adhesions, hernias, tumors, or impacted feces. Functional obstructions occur due to impaired intestinal motility, such as in cases of paralytic ileus or pseudo-obstruction.

Characteristics of Intestinal Obstruction:

• Location: Intestinal obstruction can occur in different segments of the intestine, including the small intestine (jejunum, ileum) or the large intestine (colon).
• Severity: The severity of intestinal obstruction can vary from partial blockages with intermittent symptoms to complete blockages with severe symptoms and complications.
• Symptoms: Common symptoms of intestinal obstruction include abdominal pain or cramping, bloating, nausea, vomiting, constipation, and inability to pass gas or stool.
• Complications: If left untreated, intestinal obstruction can lead to bowel ischemia, perforation, peritonitis, sepsis, and potentially life-threatening complications.

Causes and Risk Factors:

• Adhesions: Scar tissue formation from previous abdominal surgeries can cause adhesions that narrow or kink the intestines, leading to obstruction.
• Hernias: Hernias occur when a portion of the intestine protrudes through a weakened area in the abdominal wall, potentially causing obstruction.
• Tumors: Benign or malignant tumors in the intestine or adjacent organs can obstruct the intestinal lumen.
• Intussusception: This occurs when one segment of the intestine telescopes into another segment, causing obstruction.
• Volvolus: Twisting of the intestine around itself can lead to obstruction and compromised blood flow.
• Impacted Feces: Severe constipation or fecal impaction can obstruct the large intestine, particularly in elderly individuals or those with underlying bowel disorders.

Signs and Symptoms:

• Abdominal Pain: Crampy, colicky abdominal pain is a hallmark symptom of intestinal obstruction, often localized to the site of obstruction.
• Bloating: Abdominal distention and bloating may occur due to trapped gas and fluid upstream of the obstruction.
• Vomiting: Persistent vomiting may occur as the body attempts to relieve pressure and remove gastric contents.
• Constipation or Absence of Bowel Movements: Inability to pass gas or stool is common in cases of intestinal obstruction.
• Tenderness and Rigidity: Abdominal tenderness, rigidity, or guarding may be present, particularly in cases of bowel ischemia or peritonitis.