OBSTRUCTION

OBSTRUCTION

1. What is obstruction? Blocking of normal functions or processes. -There may be a structural cause of obstruction that is internal, such as a faecalith in the appendix (A stone), Or there may be an external cause of obstruction, as in the compression of a loop of intestine in an incarcerated hernia. - Obstruction may also arise from ‘functional ’ disorders in which the smooth muscle of the intestine fails to effect peristalsis.

   • What can cause obstructions? .Stones: these can occur in the kidney, gallbladder and salivary glands. - Clots may occur. tumours may cause obstructions - Fibrotic adhesions may disrupt the bowel or falopiab tube , twisting, spasm or paralysis of the bowel may mechanically obstruct it - Foreign body’s may block he ear and nose r throat - Infections may also cause obstruction - Obstruction of the lymphatic system may result in oedema which is the accumulation of fluid in interstitial spaces
     • areas of obstruction + alterated function: lungs= decreased oxygenation of blood, arterial/venous circulation= oxygenated blood to organs , urinary tract=rentention or stasis, gastrointestinal tract= inability to pass stool + infection known as peritonitis
   • PARTIAL OR COMPLETE BLOCKAGE

2. SMALL BOWEL

   • OBSTRUCTION
     • INCREASE IN SECRETORY ACTIVITY
       • INCREASE IN FLUID ACCUMULATION
         • PROXIMAL DISTENTION
   • PATHOPHYSIOLOGY STRUCTURAL: Small-bowel obstruction (SBO) leads to proximal dilatation of the intestine due to accumulation of gastrointestinal (GI) secretions and swallowed air. Bowel dilatation stimulates cell secretory activity, resulting in more fluid accumulation. This, in turn, leads to increased peristalsis above and below the obstruction, with frequent loose stools and flatus early in its course.
     • ADHESIONS: - Such tissue growing between the organs of the cavity, or between the organs and the cavity walls, may cause obstruction by trapping loops of intestine, with consequences similar to those described for hernias, or by causing kinks in the intestine that obstruct the normal flow of intestinal contents.
     • CHRON'S DISEASE:
     • INTUSSUSCEPTION: Intussusception of the bowel is defined as the telescoping of a proximal segment of the gastrointestinal tract within the lumen of the adjacent segment
     • HERNIA: Hernias- A hernia occurs when a loop of intestine pushes through a weakness in the muscular wall of the abdominopelvic cavity. The most common site for a hernia of the small intestine is the inguinal ring of males

3. ANOREXIA

4. NAUSEA

   • ANTIEMETICS

5. VOMITING

   • NIL BY MOUTH

6. WEIGHT LOSS

7. FATIGUE

8. CONSTIPATION

9. ABDOMINAL PAIN

10. LARGE BOWEL

    • AUTONOMIC IMBALANCE
      • INCREASE SNS
      • DECREASE PNS
        • MUCOSAL OEDEMA
          • GIT PERFUSION DECREASES
          • INCREASE PERMEABILITY
            • BACTERIAL TRANSLOCATION
    • Mechanical LBO causes bowel dilatation above the obstruction, which in turn, causes mucosal edema and impaired venous and arterial blood flow to the bowel. Bowel edema and ischemia increase the mucosal permeability of the bowel, which can lead to bacterial translocation, systemic toxicity, dehydration, and electrolyte abnormalities. Bowel ischemia can lead to perforation, fecal soilage of the peritoneal cavity, and dead bowel.
      • VOLVULUS: is the twisting of a loop of intestine through 360 degrees. This occludes its lumen and collapses its blood vessels (can occur in small or large bowel)
      • DIVERTICULAR DISEASE: Diverticular disease develops when pouches form along your digestive tract, typically in your colon (large intestine). These pouches are known as diverticula. They form when weak spots in your intestinal wall balloon outward
      • COLORECTAL CANCER In the large intestine, the major cause of obstruction is cancer.About half of all large-bowel obstructions are caused by colorectal cancer. Undiagnosed colon or rectal cancer may cause a gradual narrowing of the large intestine's inner passageway. Usually patients experience intermittent constipation for a while before the bowel finally becomes obstructed
      • CANCER, VOLVULUS AND DIVERTICULAR DISEASE ARE ALL EXAMPLES OF STRUCTURAL OBSTRUCTIONS THAT COMMONLY OCCUR IN LARGE BOWEL
      • CAUSES OF MECHNICAL/FUNCTIONAL OBSTRUCTIONS ALSO KNOWN AS ILEUS: The most common cause is abdominal surgery.Less frequently, ileus may result from conditions such as systemic infection, hypokalaemia, kidney disease, peritonitis, spinal cord injury or ischaemia of the intestines. In the latter case, the grave problems of necrosis, gangrene and potential rupture may occur.

11. TACHYCARDIA

12. ABDOMINAL DISTENSION

13. FEVER

14. DECREASED BOWEL SOUNDS

Images and files in the map