Bowel Obstruction

Never let the sun rise or set on a complete bowel obstruction - Old Surgical Dictum

Bowel Obstruction

image by: Armando Hasudungan

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The Sick Bowel Obstruction Patient

Bowel obstructions may present along a spectrum and can pose a diagnostic challenge, with early or low grade obstruction manifesting with non-specific symptoms and a non-focal exam in a relatively well appearing patient. Others are more obvious with classic symptoms of abdominal distention, feculent belching or emesis, significant pain, and decreased to no bowel movements/flatus. Presentation will also vary depending on the location of the obstruction (proximal versus distal).

Recognition of risk factors can aid in the timely workup and diagnosis of an ill patient with bowel obstruction. It is well known that previous abdominal surgeries are a risk factor due to development of adhesions,…

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 The Sick Bowel Obstruction Patient

Bowel obstructions are a relatively common presentation in Emergency Departments (EDs) across the country and are most often due to mechanical obstruction. The majority (~75%) of bowel obstructions occur in the small bowel), with the remainder afflicting the large bowel (LBO).

On The Wards

Bowel obstruction is a common surgical presentation. It can be categorised into small and large bowel obstruction, with key implications for management.

Harvard Health

The problem causing the blockage can be inside or outside the intestine. Inside the intestine, a tumor or swelling can fill and block the inside passageway of the intestine. Outside the intestine, it is possible for an adjacent organ or area of tissue to pinch, compress or twist a segment of bowel.

Mayo Clinic

Causes of intestinal obstruction may include fibrous bands of tissue (adhesions) in the abdomen that form after surgery; hernias; colon cancer; certain medications; or strictures from an inflamed intestine caused by certain conditions, such as Crohn's disease or diverticulitis.


An intestinal obstruction occurs when food or stool cannot move through the intestines. The obstruction can be complete or partial. There are many causes. The most common are adhesions, hernias, cancers, and certain medicines.


A bowel obstruction can either be a mechanical or functional obstruction of the small or large intestines. Obstruction frequently causes abdominal pain, nausea, vomiting, constipation, obstipation, and distention. This activity explains the pathophysiology, classification, evaluation, and management in patients with bowel obstruction. It highlights the role of the interprofessional team in treating and decreasing long term morbidity in patients with bowel obstruction.

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