3. 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% with
strangulation.
4. 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
Extramural
ADYNAMIC:- It may occur in two forms:-
Peristalsis absent ( eg. Paralytic ileus ).
Peristalsis present in non-propulsive form(eg. Mesenteric
vascular occlusion).
8. CLASSIFICATION II :- Depending on site of
obstruction
Proximal Small Distal Small Bowel Large Bowel
Bowel(Duodenum (Ileum)
and jejunum)
♦ Congenital ♦ Hernias- Common ♦ Malignancy
cause
♦ Lipomas ♦ Tuberculous
♦ Malignancy strictures
♦ Malignancy
♦ Crohn’s Disease ♦ Anorectal
♦ Bands and malformation
Adhesions ♦ Tuberculosis
strictures ♦ Volvulus
10. CLASSIFICATION IV:- According to
Pathological 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.
11. Pie chart showing relative frequency of the underlying
diagnosis of intestinal obstruction.
Pseudo - obstruction
Miscellaneous
Fecal impaction
5% 5% Adhesions
8%
Carcinoma
40%
15%
15%
12%
Obstructed Hernia
Inflammatory