Intestinal Obstruction
Definition: Syndrome due to full stop of the bowel transit a long with its consequences
Etymology
Occlusion: mechanical blocking of the bowel content progression
Ileus: functional disorders or paralytic
Occlusive= (lat.)Occludere = to deaf, to occlude, to impound
Obstruction= (lat.)Obstructus= obstacle
Ileus= (gr.)Eilein= to constrict, to strand
Acute Intestinal Occlusions
= clinics dominating etiology, various etiology, multi-vectors pathogeny
Emergency surgery
-symptomatology is leading to a correct diagnosis by its self and also for surgery decision
-a lot of diseases involved in such a syndrome
-severe prognosis
History
Speculative stage
Praxagoras (315 b.C.): enterocutaneous fistula for the decompression of a strangulated
inguinal hernia
Classic stage (absenteeism vs. interventionism) in the beginning: inflammatory
disease surgical absenteeism
up to the end of19thC.: positive diagnosis of the intestinal obstruction can be
established only by intraperitoneal exploration which is better to be performed before
death than after
Modern stage (physiopathological)
Experimental researches always emergency rebalancing, not always emergency
surgery
1
, Contemporary stage (surgical?)
Statistics
-1/5 of acute abdomen patients have intestinal obstruction
-No preference for age, sex, race
-Overall mortality: up to10%
Causes:
-postoperative adhesions60%
-colorectal neoplasia
-parietal defects (hernias, recurrent hernias)
-Crohn’s disease
Etiology
Depending on:
1. Obstruction mechanism
2. Level of the obstacle
3. Clinical evolution
4. Vascular disorder of the intestine
1. Depending on obstruction mechanism
1.1. Mechanical occlusion
-lumen is not free
-digestive continuity is interrupted
level of the obstacle:
A-Inside the lumen
B-Into the wall
2
Definition: Syndrome due to full stop of the bowel transit a long with its consequences
Etymology
Occlusion: mechanical blocking of the bowel content progression
Ileus: functional disorders or paralytic
Occlusive= (lat.)Occludere = to deaf, to occlude, to impound
Obstruction= (lat.)Obstructus= obstacle
Ileus= (gr.)Eilein= to constrict, to strand
Acute Intestinal Occlusions
= clinics dominating etiology, various etiology, multi-vectors pathogeny
Emergency surgery
-symptomatology is leading to a correct diagnosis by its self and also for surgery decision
-a lot of diseases involved in such a syndrome
-severe prognosis
History
Speculative stage
Praxagoras (315 b.C.): enterocutaneous fistula for the decompression of a strangulated
inguinal hernia
Classic stage (absenteeism vs. interventionism) in the beginning: inflammatory
disease surgical absenteeism
up to the end of19thC.: positive diagnosis of the intestinal obstruction can be
established only by intraperitoneal exploration which is better to be performed before
death than after
Modern stage (physiopathological)
Experimental researches always emergency rebalancing, not always emergency
surgery
1
, Contemporary stage (surgical?)
Statistics
-1/5 of acute abdomen patients have intestinal obstruction
-No preference for age, sex, race
-Overall mortality: up to10%
Causes:
-postoperative adhesions60%
-colorectal neoplasia
-parietal defects (hernias, recurrent hernias)
-Crohn’s disease
Etiology
Depending on:
1. Obstruction mechanism
2. Level of the obstacle
3. Clinical evolution
4. Vascular disorder of the intestine
1. Depending on obstruction mechanism
1.1. Mechanical occlusion
-lumen is not free
-digestive continuity is interrupted
level of the obstacle:
A-Inside the lumen
B-Into the wall
2
