عدد الرسائل : 4030
العمر : 29
العمل/الترفيه : المدير
السٌّمعَة : 4
نقاط : 982
تاريخ التسجيل : 02/04/2008
|موضوع: Intestinal obstruction الجمعة 17 أكتوبر 2008, 21:51|| |
Paralytic ileus; Intestinal volvulus; Bowel obstruction; Ileus; Pseudo-obstruction - intestinal; Colonic ileus
Intestinal obstruction involves a partial or complete blockage of the
bowel that results in the failure of the intestinal contents to pass
Obstruction of the bowel may be caused by ileus -- in which the bowel
doesn't function correctly but there is no "mechanical" (anatomic)
problem -- or by mechanical causes. Paralytic ileus, also called
pseudo-obstruction, is one of the major causes of obstruction in
infants and children.
Ileus - X-ray of distended bowel and stomach
Ileus - X-ray of bowel distension
The causes of paralytic ileus may include the following:
Medications, especially narcotics
Mesenteric ischemia (decreased blood supply to the support structures in the abdomen)
Injury to the abdominal blood supply
Complications of intra-abdominal surgery
Kidney or thoracic disease
Metabolic disturbances (such as decreased potassium levels)
Paralytic ileus may lead to complications causing jaundice and
electrolyte imbalances. In the newborn, paralytic ileus that is
associated with destruction of the bowel wall (necrotizing
enterocolitis) is life-threatening and may lead to infection in the
infant's blood and lungs.
In older children, gastroenteritis may be a cause of paralytic ileus,
which is sometimes associated with peritonitis and a ruptured appendix.
Paralytic ileus is marked by abdominal distention, absent bowel sounds
(no noise heard when listening to abdomen), and abdominal pain.
Mechanical obstruction occurs when movement of material through the
intestines is physically blocked. The mechanical causes of obstruction
are numerous and may include the following:
Postoperative adhesions or scar tissue
Impacted feces (stool)
Tumors blocking the intestines
Granulomatous processes (abnormal tissue growth)
Volvulus (twisted intestine)
Foreign bodies (ingested materials that obstruct the intestines)
If the obstruction blocks the blood supply to the intestine, the tissue
may die, causing infection and gangrene. Risk factors for tissue death
include intestinal malignancy, Crohn's disease, hernia, and previous
Intussusception - X-ray
Abdominal fullness, gaseous
Abdominal pain and cramping
Failure to pass gas or stool (constipation)
Exams and Tests
While listening to the abdomen with a stethoscope your health care
provider may hear high-pitched bowel sounds at the onset of mechanical
obstruction. If the obstruction has persisted for too long or the bowel
has been significantly damaged, bowel sounds decrease, eventually
Small bowel obstruction - X-ray
Early paralytic ileus is marked by decreased or absent bowel sound.
Tests that show obstruction include:
Abdominal CT scan
Upper GI and small bowel series
The objective of treatment is to decompress the intestine with suction,
using a nasogastric (NG) tube inserted into the stomach or intestine.
This will relieve abdominal distention and vomiting.
Surgery to relieve the obstruction may be necessary if decompression by
NG tube does not relieve the symptoms, or if tissue death is suspected.
The outcome varies with the cause of the obstruction.
Gangrene of the bowel
Perforation (hole) in the intestine
When to Contact a Medical Professional Return to top
Call your health care provider if persistent abdominal distention
develops and you are unable to pass stool or gas, or if other symptoms
of intestinal obstruction develop.
Prevention depends on the cause. Treatment of conditions (such as
tumors and hernias) that are related to obstruction may reduce the risk.
Some causes of obstruction are not preventable