Clinical management II Test 1
functional bowel obstruction - failure of peristalsis resulting from ileus, narcotics, overuse of
antidiarrheals
Most bowel obstruction occur in the - small intestines
-80%
Percentage of ischemic small bowel obstruction - 1/3 of those in the small bowel
Mortality rate of small bowel obstruction - 8% if operated within 24 hours
24% if operated after 30 hours
Causes of mechanical bowel obstruction - Extrinsic
-adhesions
Intrinsic
-inflammation
-intussusception
-volvulus
--twisted bowel
Intraluminal
-foreign bodies
-bezoars
-inspissated barium
,--barium that was swallowed and turns to a stone in the bowel if not passed
Inspissated barium have a higher incidense - poor hydration
poor GI motility
cause of SBO in cancer patients - living longer and have them later in life
locations of radiation associated with small bowel obstruction - the radiation is isolated to the location
of the cancer
-if they had breast cancer it will not play with lower bowel obstruction.
Most common cause of mechanical small bowel obstruction - 50% post operative adhesions
20% Neoplasms
10% Hernia
15% Intussusception or volvulus
5% Irritable bowel disease
Length of time for the small bowel to decompress - 12 to 24 hours after the bowel is obstructed
-so they will still have stool for a little bit
Complication with air accumulation in a small bowel obstruction - Increased bacteria from fermentation
-increased the distention
volvulus - closed loop obstruction
-most common precursor to strangulation
--not all will strangulate
, Clinical question regarding nausea and abdominal pain - timing of pain and nausea
The longer the amount of time from pain to vomiting the more distal the obstruction
Signs and symptoms of proximal small bowel obstruction - Vomiting is more pronounced,
less abdominal distention
Signs and symptoms of distal small bowel obstruction - Greater abdominal distention
More pain
Emesis is delayed
Rule of thumb for location of abdominal pain - The lower the location the pain the more likely it's in the
large intestine
first symptom of small bowel obstruction - pain
-vomiting comes later
Electrolyte imbalance from small bowel obstruction - Hypokalemia
Pyrexia - another term for fever
-onset of ischemia
-sign of infection
IIndication of septic shock - Hypo thermia
functional bowel obstruction - failure of peristalsis resulting from ileus, narcotics, overuse of
antidiarrheals
Most bowel obstruction occur in the - small intestines
-80%
Percentage of ischemic small bowel obstruction - 1/3 of those in the small bowel
Mortality rate of small bowel obstruction - 8% if operated within 24 hours
24% if operated after 30 hours
Causes of mechanical bowel obstruction - Extrinsic
-adhesions
Intrinsic
-inflammation
-intussusception
-volvulus
--twisted bowel
Intraluminal
-foreign bodies
-bezoars
-inspissated barium
,--barium that was swallowed and turns to a stone in the bowel if not passed
Inspissated barium have a higher incidense - poor hydration
poor GI motility
cause of SBO in cancer patients - living longer and have them later in life
locations of radiation associated with small bowel obstruction - the radiation is isolated to the location
of the cancer
-if they had breast cancer it will not play with lower bowel obstruction.
Most common cause of mechanical small bowel obstruction - 50% post operative adhesions
20% Neoplasms
10% Hernia
15% Intussusception or volvulus
5% Irritable bowel disease
Length of time for the small bowel to decompress - 12 to 24 hours after the bowel is obstructed
-so they will still have stool for a little bit
Complication with air accumulation in a small bowel obstruction - Increased bacteria from fermentation
-increased the distention
volvulus - closed loop obstruction
-most common precursor to strangulation
--not all will strangulate
, Clinical question regarding nausea and abdominal pain - timing of pain and nausea
The longer the amount of time from pain to vomiting the more distal the obstruction
Signs and symptoms of proximal small bowel obstruction - Vomiting is more pronounced,
less abdominal distention
Signs and symptoms of distal small bowel obstruction - Greater abdominal distention
More pain
Emesis is delayed
Rule of thumb for location of abdominal pain - The lower the location the pain the more likely it's in the
large intestine
first symptom of small bowel obstruction - pain
-vomiting comes later
Electrolyte imbalance from small bowel obstruction - Hypokalemia
Pyrexia - another term for fever
-onset of ischemia
-sign of infection
IIndication of septic shock - Hypo thermia
