INTESTINAL   OBSTRUCTIONPresented by8th semesterRoll no-83 to 88.
INTRODUCTION         By         Pallavi Shekhar         Roll no -83
INTRODUCTION AND DEFINITION Lack of transit of intestinal contents. Accounts for 5% of all acute surgical admissions. 8...
CLASSIFICATION I(Aetiopathology based)DYNAMIC:- Where peristalsis is working against a mechanical obstruction.          Ac...
DYNAMICINTRALUMINAL♦Impaction♦Foreign bodies Trichobezoar   Gallstones♦Tricobezoar♦ Gallstones
INTRAMURAL             EXTRAMURAL                       ♦ Bands /♦ Stricture(tubercu-     Adhesions(40%)  lous stricture) ...
ADYNAMIC♦ Paralytic ileus♦ Diabetes Mellitus♦ Pseudo – obstruction♦ Postoperative period♦ Electrolyte imbalance(hypokalemi...
CLASSIFICATION II :- Depending on site ofobstructionProximal Small   Distal Small Bowel   Large BowelBowel(Duodenum   (Ile...
CLASSIFICATION IIICONGENITAL                     ACQUIRED♦ Anorectal                   ♦ Hernia(commonest) malformations  ...
CLASSIFICATION IV:- According toPathological ChangesSimple – where blood supply is intactStrangulated – where there is d...
Pie chart showing relative frequency of the underlyingdiagnosis of intestinal obstruction.                    Pseudo - obs...
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Introduction of intestinal obstruction Pallavi Shekhar Medical College kolkata

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Introduction of intestinal obstruction Pallavi Shekhar Medical College kolkata

  1. 1. INTESTINAL OBSTRUCTIONPresented by8th semesterRoll no-83 to 88.
  2. 2. INTRODUCTION By Pallavi Shekhar Roll no -83
  3. 3. 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.
  4. 4. 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).
  5. 5. DYNAMICINTRALUMINAL♦Impaction♦Foreign bodies Trichobezoar Gallstones♦Tricobezoar♦ Gallstones
  6. 6. INTRAMURAL EXTRAMURAL ♦ Bands /♦ Stricture(tubercu- Adhesions(40%) lous stricture) ♦ Hernia(25%)♦ Malignancy ♦ Volvulus♦ Crohn’s Disease ♦ Intussuception Crohn’s disease
  7. 7. ADYNAMIC♦ Paralytic ileus♦ Diabetes Mellitus♦ Pseudo – obstruction♦ Postoperative period♦ Electrolyte imbalance(hypokalemia)♦ Retroperitoneal haemorrhage♦ Spinal injuries♦ Mesenteric ischemia
  8. 8. CLASSIFICATION II :- Depending on site ofobstructionProximal Small Distal Small Bowel Large BowelBowel(Duodenum (Ileum)and jejunum)♦ Congenital ♦ Hernias- Common ♦ Malignancy cause♦ Lipomas ♦ Tuberculous ♦ Malignancy strictures♦ Malignancy ♦ Crohn’s Disease ♦ Anorectal♦ Bands and malformationAdhesions ♦ Tuberculosis strictures ♦ Volvulus
  9. 9. CLASSIFICATION IIICONGENITAL ACQUIRED♦ Anorectal ♦ Hernia(commonest) malformations ♦ Postoperative♦ Congenital megacolon ♦ Intussusceptions Intussusceptions♦ Duodenal atresia ♦ Gallstones♦ Volvulus ♦ Tuberculosis♦ Bands and adhesions ♦ Malignancy♦ Intestinal atresia(ileal) ♦ Roundworm
  10. 10. CLASSIFICATION IV:- According toPathological ChangesSimple – where blood supply is intactStrangulated – where there is direct interference to blood flow.Closed loop obstruction – when bowel obstructed both at proximal and distal points.
  11. 11. 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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