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Introduction of intestinal obstruction Pallavi Shekhar  Medical College kolkata
 

Introduction of intestinal obstruction Pallavi Shekhar Medical College kolkata

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Pallavi Shekhar Medical College kolkata

Pallavi Shekhar Medical College kolkata

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    Introduction of intestinal obstruction Pallavi Shekhar  Medical College kolkata Introduction of intestinal obstruction Pallavi Shekhar Medical College kolkata Presentation Transcript

    • 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. 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).
    • DYNAMICINTRALUMINAL♦Impaction♦Foreign bodies Trichobezoar Gallstones♦Tricobezoar♦ Gallstones
    • INTRAMURAL EXTRAMURAL ♦ Bands /♦ Stricture(tubercu- Adhesions(40%) lous stricture) ♦ Hernia(25%)♦ Malignancy ♦ Volvulus♦ Crohn’s Disease ♦ Intussuception Crohn’s disease
    • ADYNAMIC♦ Paralytic ileus♦ Diabetes Mellitus♦ Pseudo – obstruction♦ Postoperative period♦ Electrolyte imbalance(hypokalemia)♦ Retroperitoneal haemorrhage♦ Spinal injuries♦ Mesenteric ischemia
    • 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
    • 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
    • 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.
    • 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