Aetiology of intestinal obstruction
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Aetiology of intestinal obstruction

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  • Crohn’s disease

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  • 1. Dynamic  Extramural Intraluminal bands/adhesions impaction hernia foreign bodies Volvulus bezoars Intussusception gallstones Intramural Adynamic stricture Paralytic ileus malignancy Mesenteric vascular occlusion Pseudo -obstruct
  • 2. ADHESIONTUMOR
  • 3. A portion of the SI becomes entrapped in oneof the retroperitoneal fossae or in a congenitalmesenteric defectSites Foramen of Winslow Holes in the mesentery or transversemesocolon Defect in the broad ligament Diaphragmatic hernia Duodenal/caecal/appendicealretroperitoneal fossae
  • 4. Secondary to tuberculosis or crohn’s diseaseTreatment- Resection & anastomosis
  • 5. 1. Gall stones In the elderly 20 to erosion of a large gallstone through the gallbladder into the duodenum Classically there is impaction about 60 cm proximal to the ileocaecal valve
  • 6. 2. Food Occur after partial or total gastrectomy when unchewed articles can pass into the small bowel3. Stercolith In association with jejunal diverticulum or ileal stricture
  • 7. 4. Trichobezoar Firm masses of undigested hair balls Associated with an underlying psychiatric abnormality
  • 8. 5. Phytobezoar Firm masses of fruit or vegetable fibres Predisposing factors High fibre intake Inadequate chewing Previous gastric surgery Hypochlorhydria Loss of the gastric pump mechanism
  • 9. 6. Worms Ascaris Lumbricoides In children An attack frequently follows the initiation of antihelminthic therapy
  • 10. Common cause of intestinal obstruction inwestern countriesAny peritoneal irritation → local fibrinproduction → adhesions between opposedsurfacesCauses Ischemic areas- Sites of anastomoses, trauma vascular occlusion Foreign material- Talc , starch, gauze, silk Infection- Peritonitis, tuberculosis Inflammatory conditions- Crohn’s disease Radiation enteritis
  • 11. INTUSSUSCEPTION One portion of the gut becomes invaginated within an immediately adjacent segment Commonly in children(5-10 months) 90% idiopathic Secondary to intestinal pathology. Eg. Polyp, Meckels diverticulum Hyperplasia of the Peyer’s patch in the terminal ileum may be the initiating event
  • 12. Twisting or axial rotation of a portion of bowelabout its mesenteryPrimary or secondary10 – occurs secondary to congenital malrotationof the gut, abnormal mesentericattachments, congenital bands20 – rotation of a piece of bowel around anacquired adhesion or stoma