Bowel Obstruction- Dangerous, Why?

Small intestinal obstruction may be due to mechanical causes or paralysis. Although impotence is more common, it is often self-limiting and does not require surgery. Mechanical switches can be caused by internal or external factors. If the small intestine is completely obstructed, untimely treatment can lead to peritonitis and death.
Why is obstruction of the small intestine?
A person with a small intestinal obstruction often has the following causes: intestinal adhesion, hernia, cancer accounting for more than 90% of cases

. Postoperative intestinal adhesion was the most common cause of obstruction in the small intestine (56%).
Stuffy hernia accounts for (25%). Sticky bowel obstruction accounts for about 5% of postoperative patients An inguinal hernia and a hernia may also be involved.




Other less common causes include: cancer, inflammatory bowel disease, gallstones, intestinal torsion, intussusception, abscess, congenital lesions, roundworm ...
Signs identify small intestine
When intestinal obstruction, patients often abdominal pain and abdominal distention. The nature of cramping, sometimes spasm in the epigastrium or around the navel
When clogged, the small intestine reflexes often cause more distention. The patient vomited and had central retention, defecation. Vomiting usually occurs late, if vomiting of stool is caused by a blockage at the end of the small intestine Secret, the most obvious defecation when all stool in the intestinal segment below the blockage is indented.




When the small bowel obstruction is at an early stage, it can be difficult to diagnose.
However, when partial or complete early bowel obstruction has similar symptoms, care should be taken to distinguish it from complete obstruction.
Abdominal examination often shows patients with diffuse pain. Attention should be paid to the detection of hernias or tumors. A rectal exam usually shows only an empty arch, but can sometimes detect a tightly lumped tumor or stool.
When the intestines are blocked, the intestinal fluid becomes filled with a decrease in absorption and an increase in fluid secretion. The secretions of the stomach, pancreas, bile fluid also accumulate in the intestine.
The fluid may seep through the intestinal wall causing intestinal wall edema and may leak into the peritoneum.



Due to intestinal fluid retention, excessive vomiting leads to dehydration and serious electrolyte leads to shock.
If this process is prolonged, the intestine relaxes, blood vessel damage, increased intestinal pressure or strangulation can lead to necrosis and perforation.
Bacteria from the intestine enter the damaged intestinal wall, proliferate and invade the peritoneum causing peritonitis to lead to high mortality.
Complete bowel obstruction is often difficult to distinguish from early bowel obstruction. Patients with bowel obstruction may have fever, tachycardia, pronounced abdominal pain, peritoneal sensitization, reduced bowel sounds, or a late-stage tumor.
The test can cause metabolic acidosis, amylase ...



X-ray signs of a closed loop include signs of coffee beans, cystic ligament, stretching of the airway with the heart separated by a large, dense edematous intestinal tract. pseudomembranous tumor sign: fluid-filled loop like a tumor.
Non-prepared film has sensitivity of 41 - 86% and specificity of 25 - 85%. Abdominal CT scan has 100% sensitivity and 83% specificity, so it is very valuable for diagnosis.
Treatment and prevention
Emergency a case of intestinal obstruction including: cardiopulmonary support, electrolyte supplement, nasal catheterization to reduce pressure, use antibiotics to fight infections. Because it is difficult to distinguish a clogged small intestine from a complete small intestinal obstruction, early surgical consultation is needed.
If incomplete bowel obstruction is usually treated without surgery for about 48 hours, otherwise the outcome should be surgical early.
Treatment of paralytic ileus requires maintaining the volume in the blood vessels.



Limit oral intake, regulate electrolytes, especially reduce potassium.
A nasogastric tube or mouth-to-mouth catheter is needed to treat the symptoms of bloating and discomfort.
Immediately stop drugs that slow intestinal motility such as opiate. In case of paralytic ileus lasting more than 3-5 days, imaging should be taken to detect the cause of intestinal obstruction.
Prevention: need to treat well the diseases that cause intestinal stickiness, hernia, postoperative laparoscopy, cancer, enteritis, gallstones, intussusception, abscess, roundworm ....

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