Bsc and Gnm Nursing Syllabus

1. INTESTINAL OBSTRUCTION

2. INTESTINAL OBSTRUCTION
• It is a mechanical or functional obstruction of
the intestine preventing the normal transit of
the products of digestion.
• Occurs in about 1 in 1,500 live births.

3. TYPES
1. Small bowel
obstruction
2. Large bowel
obstruction

4. ETIOLOGY

5. SMALL BOWEL OBSTRUCTION
• Adhesions from previous surgery
• Crohn’s Disease (Inflammatory bowel diseases)
• Neoplasms (abnormal growth of tissue)
• Hernias containing bowel

6. • Volvulus (an obstruction caused by twisting of the stomach or intestine.)
• Ischemic structures.
• Foreign bodies.
• Intestinal atresia.
SMALL BOWEL OBSTRUCTION

7. LARGE BOWEL OBSTRUCTION
1. Neoplasms.
2. Hernias.
3. Inflammatory bowel disease.
4. Colonic volvulus.
5. Constipation.
6. Fecal impaction ( Hardened stool).
7. Colon atresia.
8. Benign strictures.

8. CLINICAL FEATURES
• Abdominal pain and distention.
• Vomiting.
• Constipation.
• Dehydration and electrolyte abnormalities.
• Respiratory difficulty.

9. Small bowel obstruction:
• Colicky pain with spasms lasting for few minutes in mid abdomen.
• Vomiting occurs before constipation.
Large bowel obstruction
• Pain in the lower abdomen and spasms last longer.
• Constipation occurs earlier and vomiting may be less prominent.
CLINICAL FEATURES

10. DIAGNOSTIC EVALUATION
• Serum electrolyte level
• Urinalysis
• Stool for occult blood
• X rays: Barium meal
• CT Scan
• USG

11. MEDICAL MANAGEMENT
• IV fluids administration
• Opioids for severe pain
• Antiemetic's
• Bowel decompression with a nasogastric tube
• Broad spectrum antibiotics.

12. SURGICAL MANAGEMENT
• If small portion of intestine is affected:
Resection and end to end anastomosis.
• If large portion of intestine is affected:
Temporary colostomy later on followed by end to end anastomosis
of the normal intestine.