bowel obstruction is a condition where there is a partial or complete blockage of the small or large intestine. This obstruction prevents the passage of food, fluids, and gases in the intestine, leading to severe pain. bowel obstruction is a medical emergency that requires immediate intervention.
Causes of bowel obstruction may include:
1. Adhesions of the intestine due to previous abdominal and bowel surgeries.
2. Growths in the bowel area.
3. Hernia.
4. Inflammatory bowel diseases like Crohn's disease and colitis.
5. Gallstones and foreign bodies.
6. Intussusception, which is more common in children.
At the onset of the obstruction, the intestine tries to overcome the blockage, leading to increased peristalsis (movement) on both sides of the obstruction.
Symptoms of bowel obstruction may include:
- Nausea and vomiting of stool.
- Abdominal distension.
- Constipation and the inability to pass gas.
- Abdominal pain.
There is a risk of dehydration, manifested by rapid pulse and low blood pressure, leading to hypovolemic shock. Without treatment, the pressure on the walls of the intestine can cause perforation (rupture) of the intestine, allowing its contents to spill into the abdominal cavity, leading to a life-threatening infection.
Diagnosis of bowel obstruction involves physical examination, laboratory tests, abdominal X-rays, and abdominal CT scans.
Treatment options for bowel obstruction can be either conservative or surgical:
1. Conservative treatment is used when the obstruction is mild and uncomplicated. It usually involves intravenous fluids and electrolytes, the insertion of a nasogastric tube, and bowel rest followed by close monitoring.
2. Surgical treatment is necessary when the obstruction is severe with strangulation (cutting off blood supply) of the intestine. The surgical approach will depend on the cause of the obstruction. For example, if there is a growth causing the blockage, the affected area may be released by creating a stoma (an opening in the abdominal wall with a bag for waste collection) followed by neoadjuvant treatment for the growth, and then planning a surgery to remove the growth itself. Depending on the patient's condition, reconnecting the intestine by surgical anastomosis near the original part of the intestine or on the distant part may also be considered.