This document outlines the clinical classification, presentation, symptoms, and signs of bowel obstructions. It discusses high vs low small bowel obstructions and complete vs incomplete obstructions. Symptoms discussed include pain, vomiting, distension, constipation, dehydration, and hypokalaemia. Signs include abdominal tenderness, bowel sounds, and surgical emergencies involving constant severe pain, tenderness with rigidity and shock. Specific conditions like sigmoid volvulus and caecal volvulus are also mentioned.

2.  Clinically classified as –
A) High small bowel obstruction
B) Low small bowel obstruction
C) Large bowel obstruction

3.  Nature of presentation –
A) Complete obstruction
B) Incomplete obstruction
Obstruction can be simple or strangulated.

4.  PAIN-
 Sudden and severe
 Colicky in nature
 Small bowel – Umbilicus
Large bowel – Lower abdomen
 Distension and strangulation

5.  VOMITING-
 Small bowel – Early
Large bowel – Delayed
 Character of vomitus changes
 DISTENSION-
 Dependant on site of obstruction
 Visible peristalsis

6.  CONSTIPATION-
 Absolute
 Relative
 No enema

7.  DEHYDRATION –
 Common in small bowel obstruction
 Features

8.  HYPOKALAEMIA-
 Simple mechanical obstruction with strangulation
 PYREXIA-
 Rare
 Indicative – ischaemia
intestinal perforation
inflammation
abscess

9.  Abdominal tenderness
 Bowel sounds – High pitched

10.  Surgical emergency
 Constant severe pain
 Tenderness with rigidity
 Shock

11.  Common in males
 6 to 9 months
 Colicky pain  Severe pain
 Distension
 Passage of red currant jelly stools

12.  On examination,
 Mass – Sausage shaped
 Smooth, firm, resonant
 Mobile
 Does not move with respiration
 Sign of Dance

14.  Sigmoid volvulus
 Caecal volvulus
 Small intestine volvulus

15.  Pain
 Absolute constipation
 Abdominal distension
 Late vomiting
 Dehydration

16.  Paralytic ileus –
 Marked abdominal distension
 Vomiting
 Tachycardia
 Respiratory distress
 Dull abdominal pain