INTRODUCTION AND DEFINITION Lack of transit of intestinal contents. Accounts for 5% of all acute surgical admissions. 80% occurs in small bowel 20% occurs in colon Mortality in 3% without strangulation which increases to 30% withstrangulation.
CLASSIFICATION I(Aetiopathology based)DYNAMIC:- Where peristalsis is working against a mechanical obstruction. According to the site of obstruction it is further classified into Intraluminal Intramural ExtramuralADYNAMIC:- It may occur in two forms:- Peristalsis absent ( eg. Paralytic ileus ). Peristalsis present in non-propulsive form(eg. Mesenteric vascular occlusion).
CLASSIFICATION IV:- According toPathological ChangesSimple – where blood supply is intactStrangulated – where there is direct interference to blood flow.Closed loop obstruction – when bowel obstructed both at proximal and distal points.
Pie chart showing relative frequency of the underlyingdiagnosis of intestinal obstruction. Pseudo - obstruction Miscellaneous Fecal impaction 5% 5% Adhesions 8%Carcinoma 40% 15% 15% 12% Obstructed Hernia Inflammatory
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