Mary O’Reilly is a 55-year-old Woman Part 1 Small
Bowel Obstruction Case Study GRADED A+
define small bowel obstruction - ANSWER: interruption of normal passage through
the bowel
most common cause of small bowel obstruction is - ANSWER: adhesions
classification of SBO - ANSWER: - by etiology
- by degree of obstruction
- by associated complication
classification of SBO / etiology - ANSWER: - mechanical
- paralytic ileus
mechanical bowel obstruction - ANSWER: the interruption of normal passage
through the bowel due to structural barrier (tumor, adhesion)
- extrinsic
- intrinsic
mechanical bowel obstruction \ extrinsic - ANSWER: 1. bowel adhesion due to hx of
surgery
2. volvulus
3. incarcerated hernia
4. intra abdominal masses
mechanical bowel obstruction \ intrinsic - ANSWER: - intramural
- intraluminal
Intramural Bowel Obstruction - ANSWER: etiology arise from intestinal wall
1. strictures / CD
2. intestinal tumors
3. diverticulitis
4. intussusception
5. hematomas; trauma or warfarin here no need for op.
intraluminal bowel obstruction - ANSWER: etiology lies within the GI lumen.
1. gallstone ileus
2. foreign body
3. bezoars
4. fecal impaction
superior mesenteric artery syndrome - ANSWER: bowel obstruction due to
compression of the third portion of the third portion of the duodenum bw the aorta
and the SMA.
- narrowing of the angle bw SMA and aorta = compression of the duodenum.
, - congenital vs acquired as a result of sudden extreme weight loss
paralytic ileus - ANSWER: temporary functional impairment of peristalsis in the
absence of a mechanical obstruction
functional bowel obstruction causes - ANSWER: 1. retroperitoneal hematoma
2. post op; laparotomies
3. drugs; narcotics
4. peritonitis; generalized or localized (sentinel loop)
classification of SBO / degree of obstruction - ANSWER: - complete bowel
obstruction
- partial bowel obstruction
complete bowel obstruction - ANSWER: - total obstruction of the intestinal lumen,
preventing the passage of air and fluid.
- rapid progression of clinical feature
- obstipation
Obstipation - ANSWER: complete inability to passage stool and gases
partial bowel obstruction - ANSWER: partial obstruction of the lumen allowing a
small amount of air and fluid to pass through.
- clinical features are less severe
closed loop obstruction - ANSWER: - a form of complete bowel obstruction
- when a segment of intestine is obstructed in two locations creating a segment with
no proximal or distal outlet
-early identification and treatment are important to restore perfusion to the affected
segment of bowel
- rapid progression and risk of strangulation
closed loop obstruction \ single site of obstruction - ANSWER: in volvulus or
incarcerated hernia
closed loop obstruction \ multiple sites of obstruction - ANSWER: obstructing
colorectal cancer with a competent ileocecal valve.
classification of SBO / complication - ANSWER: - simple bowel obstruction
- complicated bowel obstruction
simple bowel obstruction - ANSWER: obstruction with no evidence of complications
(no features of bowel ischemia or bowel perforation)
complicated bowel obstruction - ANSWER: obstruction with strangulation, ischemic
necrosis or perforation.
Bowel Obstruction Case Study GRADED A+
define small bowel obstruction - ANSWER: interruption of normal passage through
the bowel
most common cause of small bowel obstruction is - ANSWER: adhesions
classification of SBO - ANSWER: - by etiology
- by degree of obstruction
- by associated complication
classification of SBO / etiology - ANSWER: - mechanical
- paralytic ileus
mechanical bowel obstruction - ANSWER: the interruption of normal passage
through the bowel due to structural barrier (tumor, adhesion)
- extrinsic
- intrinsic
mechanical bowel obstruction \ extrinsic - ANSWER: 1. bowel adhesion due to hx of
surgery
2. volvulus
3. incarcerated hernia
4. intra abdominal masses
mechanical bowel obstruction \ intrinsic - ANSWER: - intramural
- intraluminal
Intramural Bowel Obstruction - ANSWER: etiology arise from intestinal wall
1. strictures / CD
2. intestinal tumors
3. diverticulitis
4. intussusception
5. hematomas; trauma or warfarin here no need for op.
intraluminal bowel obstruction - ANSWER: etiology lies within the GI lumen.
1. gallstone ileus
2. foreign body
3. bezoars
4. fecal impaction
superior mesenteric artery syndrome - ANSWER: bowel obstruction due to
compression of the third portion of the third portion of the duodenum bw the aorta
and the SMA.
- narrowing of the angle bw SMA and aorta = compression of the duodenum.
, - congenital vs acquired as a result of sudden extreme weight loss
paralytic ileus - ANSWER: temporary functional impairment of peristalsis in the
absence of a mechanical obstruction
functional bowel obstruction causes - ANSWER: 1. retroperitoneal hematoma
2. post op; laparotomies
3. drugs; narcotics
4. peritonitis; generalized or localized (sentinel loop)
classification of SBO / degree of obstruction - ANSWER: - complete bowel
obstruction
- partial bowel obstruction
complete bowel obstruction - ANSWER: - total obstruction of the intestinal lumen,
preventing the passage of air and fluid.
- rapid progression of clinical feature
- obstipation
Obstipation - ANSWER: complete inability to passage stool and gases
partial bowel obstruction - ANSWER: partial obstruction of the lumen allowing a
small amount of air and fluid to pass through.
- clinical features are less severe
closed loop obstruction - ANSWER: - a form of complete bowel obstruction
- when a segment of intestine is obstructed in two locations creating a segment with
no proximal or distal outlet
-early identification and treatment are important to restore perfusion to the affected
segment of bowel
- rapid progression and risk of strangulation
closed loop obstruction \ single site of obstruction - ANSWER: in volvulus or
incarcerated hernia
closed loop obstruction \ multiple sites of obstruction - ANSWER: obstructing
colorectal cancer with a competent ileocecal valve.
classification of SBO / complication - ANSWER: - simple bowel obstruction
- complicated bowel obstruction
simple bowel obstruction - ANSWER: obstruction with no evidence of complications
(no features of bowel ischemia or bowel perforation)
complicated bowel obstruction - ANSWER: obstruction with strangulation, ischemic
necrosis or perforation.
