Small Bowel Obstruction

Bowel obstruction is a mechanical or functional obstruction of the intestines, preventing the normal transit of the products of digestion. It can occur at any level distal to the duodenum of the small intestine and is a medical emergency and surgical problem.

Causes: ABCD
- Adhesions
- Bulge eg: Hernias
- Carcinomas
- Diverticular disease ( If large bowel)

other causes:
- Crohn's disease
- Gallstones ileus
- Intussusception
- TB
- Volvulus
- Foreign body

Clinical features:
- Vomiting
- Abdominal pain
- Abdominal distension
- Constipation

Auscultation: high-pitched bowel sound

Investigations:
- Colonoscopy
- PFA
- Barium enema
- CT

Treatment:
Non-surgical (conservative) and surgical,

• Conservative treatment- insertion of NG tube, correction of dehydration and electrolyte abnormalities ( 'Drip And Suck').
• Opiod- forsevere pain.
• Antiemetics- for vomiting.
  
• Adhesive obstructions often settle without surgery. If obstruction is complete a surgery is required.

Small bowel obstruction caused by Crohn's disease, peritoneal carcinomatosis, sclerosing peritonitis and postpartum bowel obstruction are typically treated conservatively without surgery.

Complications:

• Infection
• Gangrene of the bowel
• Perforation in the intestine