5. Features vary according to :
• Site of obstruction .
• Age of Presentation.
• Underlying pathology.
• The presence or absence of intestinal
ischemia.
7. Definitions:
• Ileus : Mechanical or functional intes.
Obstruction (Adynamic or paralytic).
• Mechanical obstruction :complete or partial
blockage of the intes. Lumen.
• Simple obstruction: one obstructing point.
• Closed loop obstruction :both the afferent and
the efferent loops are obstructed.
• Strangulation : where the blood supply to the
affected part of the intestine is impaired more
likely to sustained increased intraluminal
pressur.
33. Medical causes of small & Large
bowel obstruction
Medications
Response to
localized
Inflammatory
process
Diffuse
peritonitis
Retroperitoneal
process
Neuropathic
disorders
Post. Operative
ileus
Metabolic
cases
34. Medical causes of small & Large
bowel obstruction
Metabolic:
1. Hypokalemia.
2. Hypomagnesemia.
3. Hyponatremia.
4. Ketoacidosis.
5. Uremia.
6. Porphyria.
7. Heavy metal poisoning.
36. For optimal treatment to be instituted,
five questions must be answered:
• Is the diagnosis intestinal obstruction?. Is
the obstruction is mechanical? .
• What is the level of obstruction?.
• Is there evidence of bowel wall ischemia or
perforation?.
• How sever is the associated systemic
disorders?.
39. Post. Operative ileus following
intra-abdominal surgery:
AS the motility usually returns for
the:
small bowel within 24 – 48 hrs.
gastric within 48 hrs.
colonic within 3-5 days.
