Bowel Obstruction
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Introduction
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Causes and Risk Factors
Adhesions and hernias are the most common causes.
Large bowel obstruction tends to occur in the older population. Most occur in the sigmoid colon, where the lumen is narrower. Causes include primary or metastatic cancer, diverticulitis, volvulvus, ischemia, or adhesions.
Pathophysiology
Signs and Symptoms
- history
- physical exam
History
Physical Exam
Investigations
- lab investigations
- diagnostic imaging
Lab Investigations
Diagnostic Imaging
Stepladder appearance on AXR in small bowel obstruction, or string of pearls - small bubbles of gas trapped between folds.
Large bowel obstruction
Dilated loops of colon >6cm or cecum >8 cm may be seen. The cecum dilates to the greatest extent, regardless of site of obstruction.
Differential Diagnosis
Treatments
Consequences and Course
The large bowel has a high risk of perforation when the cecum is >10cm
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Additional Resources
Topic Development
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