Bowel obstruction

Intestinal obstruction - threatening disease, characterized by a number of serious disorders, connected with the violation promote intestinal contents (up to a full stop) through the intestines. Can occur at any age, from the first days of life until old age, most men.
According to the degree of violation distinguish bowel obstruction full and partial (relative)for acute where the cross guts broken suddenly, usually completely (ileus), and chronic, developing gradually or manifested by repeated bouts relative obstruction (intermittent bowel obstruction). Ileus is included in the notion of acute abdomen (see). Depending on the mechanism of development distinguish bowel obstruction mechanical arising from the presence of obstacles (tumor, spike and others) in any area of the gastrointestinal tract, and dynamic, based on the motor function of the intestine.
Mechanical bowel obstruction can be obstructive or strangulation. In obstructive a narrowing of the lumen of the intestine (scar tumor), blockage of it (the ball of Ascaris), compression of the intestine (inflammatory infiltrate, soldering) without material breach mesenteric and intestinal circulation. When strangulation intestinal obstruction (to this type of bowel obstruction include inversion intestine, slobtsova, infringement, check it out here) along with the closing of the lumen of the intestine is compression of the veins and nerves of the mesentery, leading to rapid malnutrition one or another section of the intestine wall and his mortification. Among the factors that predispose to the emergence of strangulation intestinal obstruction, the most important anatomical features of the intestine. For example, the inversion of the sigmoid colon, as a rule, is connected with the excessive length of the colon and its mesentery; the inversion of the small intestine contributes congenital prolongation of the mesentery, the inversion blind gut - mobility cecum and the presence of the mesentery of the ascending colon.
Dynamic obstruction of the bowel may be paralytic at which the motor function of the intestine, rectum, sharply decreases to a full stop (paralysis), and spastic, characterized by the development of spasm. The reason dynamic intestinal obstruction are factors (toxic, reflex), leading to the breakdown of the normal innervation and peristalsis of the bowel. Paralytic ileus is most clearly expressed in peritonitis, to a lesser extent after surgical interventions on the abdominal organs, with injuries of the abdomen, especially with bleeding in the mesentery. Spastic form of bowel obstruction is rare. It occurs can play the role of chronic lead poisoning, irritation of the intestinal wall foreign body, Ascaris. Unlike mechanical, dynamic obstruction of the bowel necrosis of the intestine wall is not happening. Only when the dynamic of bowel obstruction caused by thrombosis of vessels of a mesentery, may develop quickly eliminate the bowel wall.
Pathological changes in intussusception are local and General nature. Local happen stretching the walls of the bowel, reducing its absorption capacity, increased secretions, compression of blood vessels and nerves, leading to necrosis of the intestinal wall, the development of peritonitis. General disorders in the body in intussusception are crucial for the course and outcome of the disease. Violation of promoting food masses, upset processes of digestion and absorption in the intestine leading to significant biochemical changes in the body. Decreases blood levels of potassium chloride and sodium, which determines the development of muscle weakness. Repeated vomiting and loss of fluids leads to dehydration and protein starvation of the body. All this along with the development of inflammatory process in the abdominal cavity causes a violation of the cardiovascular and nervous systems. The compression of the nerve endings in strangulated intestine accompanied by severe pain, causing a number of patients in shock. The combination of different pathological changes determines the severity of the General condition of the organism in intussusception.
For mechanical intestinal obstruction and speed of development of pathological processes in the intestine depend on the form of intestinal obstruction and level of obstruction of the intestine. The most rapid process proceeds at strangulation bowel obstruction: mortification of the intestinal wall can occur already in 4-5 hours. after the disease. Obstructive bowel obstruction is characterized by a slower period: from the appearance of the first signs up expressed events obstruction sometimes passes through 3-7 days. For dynamic intestinal obstruction largely depends on its cause. Severe morphological changes and peritonitis if dynamic impassability occur rarely and only in advanced cases of the disease.

  • Clinical presentation and course of acute intestinal obstruction
  • The clinical picture of chronic intestinal obstruction
  • Bowel obstruction in children