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INTESTINAL OBSTRUCTION
MS. BEENA VAZA
DEFINITION
• Interruption of normal passage of
intestinal contents.
CLASSIFICATION
1.MECHANICAL (DYNAMIC) :
- Bowel capable of contracting normally or excessively
proximal to a local site of obstruction.
2. NON – MECHANICAL (ADYNAMIC) :
- Peristalsis maybe absent ( paralytic ileum) or present in
non – propulsive form ( mesenteric vascular occlusion ,
pseudo – obstruction)
CAUSES OF SMALL BOWEL OBSTRUCTION
• Adhesion and bands following abdominal surgery
• External hernia
• Intussusceptions
• Volvulus
• Neoplasm ( Benign or Malignant)
• Obstruction due to worms.
• Stricture due to IBD
CAUSES OF LARGE BOWEL OBSTRUCTION
• Large bowel cancer.
• Sigmoid diverticular disease.
• Sigmoid volvulus.
• Retroperitoneal hematoma following lumber
fracture or lumber surgery
PATHOPHYSIOLOGY
Due to etiological factors
Blockage in the intestine
Impairment of the passage of material through the bowel
Due to blockage distention of the proximal intestine.
Necrosis and perforation of the bowel
Inflammatory response
SIGN & SYMPTOMS
• Abdominal pain
• Vomiting
• Constipation
• Distention
• Dry skin
• Small volume concentrated
urine
• Fever
• Tachycardia
• Leukocytosis
• Rebound tenderness
• Rigidity
• Sock
• Poor skin turgor
DIAGNOSTIC EVALUATION
• History collection
• Physical examination
• LABORATORY TESTS :
- CBC
- serum electrolytes and
amylase determination
- ABG analysis
• RADIOLOGICAL EXAMINATION:
- sigmoidoscopy
- Abdominal X – ray
- USG
- CT scan
MEDICAL MANAGEMENT
• NON – OPERATIVE :
• Simple obstruction
• No strangulation
• Gastrointestinal decompression : NG tube
• IV fluid
• Antibiotics
SURGICAL MANAGEMENT
• Replace fluid before surgery
• Bowel resection :
- This procedure is called bowel resection. If a section is
removed, the healthy ends will be reconnected with stiches or
staples.
- sometimes , when part of the intestine is removed , the ends
cannot be reconnected .
- if this happens, the surgeon will bring one end cut through an
opening in the abdominal wall.
NURSING MANAGEMENT
• NURSES RESPONSIBILITY

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INTESTINAL OBSTRUCTION.pptx...smart study..

  • 2. DEFINITION • Interruption of normal passage of intestinal contents.
  • 3. CLASSIFICATION 1.MECHANICAL (DYNAMIC) : - Bowel capable of contracting normally or excessively proximal to a local site of obstruction. 2. NON – MECHANICAL (ADYNAMIC) : - Peristalsis maybe absent ( paralytic ileum) or present in non – propulsive form ( mesenteric vascular occlusion , pseudo – obstruction)
  • 4. CAUSES OF SMALL BOWEL OBSTRUCTION • Adhesion and bands following abdominal surgery • External hernia • Intussusceptions • Volvulus • Neoplasm ( Benign or Malignant) • Obstruction due to worms. • Stricture due to IBD
  • 5. CAUSES OF LARGE BOWEL OBSTRUCTION • Large bowel cancer. • Sigmoid diverticular disease. • Sigmoid volvulus. • Retroperitoneal hematoma following lumber fracture or lumber surgery
  • 6.
  • 7.
  • 8. PATHOPHYSIOLOGY Due to etiological factors Blockage in the intestine Impairment of the passage of material through the bowel Due to blockage distention of the proximal intestine. Necrosis and perforation of the bowel Inflammatory response
  • 9. SIGN & SYMPTOMS • Abdominal pain • Vomiting • Constipation • Distention • Dry skin • Small volume concentrated urine • Fever • Tachycardia • Leukocytosis • Rebound tenderness • Rigidity • Sock • Poor skin turgor
  • 10. DIAGNOSTIC EVALUATION • History collection • Physical examination • LABORATORY TESTS : - CBC - serum electrolytes and amylase determination - ABG analysis • RADIOLOGICAL EXAMINATION: - sigmoidoscopy - Abdominal X – ray - USG - CT scan
  • 11. MEDICAL MANAGEMENT • NON – OPERATIVE : • Simple obstruction • No strangulation • Gastrointestinal decompression : NG tube • IV fluid • Antibiotics
  • 12. SURGICAL MANAGEMENT • Replace fluid before surgery • Bowel resection : - This procedure is called bowel resection. If a section is removed, the healthy ends will be reconnected with stiches or staples. - sometimes , when part of the intestine is removed , the ends cannot be reconnected . - if this happens, the surgeon will bring one end cut through an opening in the abdominal wall.