Intestinal obstruction

Intestinal obstruction

Introduction 

Intestinal obstruction also termed commonly as “ blockage of intestine” to describe the patients is very commonly encountered in emergency settings. These patients are categorised under acute abdominal pain in surgical emergencies. This disease is  commonly seen across all ages and genders in routine emergencies. There are multiple causes of intestinal obstruction and are generally classified as partial and complete intestinal obstruction of intestine. The obstruction can be in any part of small intestine and large intestine.

Common causes of intestinal obstruction 

  1. Congenital  bands / adhesions in the abdominal cavity 
  2. Adhesions after surgery 
  3. Cancers of small intestine and large intestine 
  4. Lumps and cancers of the organs inside the abdominal cavity 
  5. Malrotation of the small and large intestine 
  6. Groin and ventral hernias
  7. Other diseases like intussusception, diverticular disease

Symptoms of intestinal obstruction 

  1. Intense generalised pain abdomen 
  2. Distension of abdomen 
  3. Vomiting and  not able to pass stools or flatus 
  4. Localised pain in case of obstruction in hernia 
  5. Fever in case of infection and long standing obstruction
  6. Presence of lump in the abdomen 
  7. Systemic illness in case of cancers

These symptoms should not be ignored and get yourself checked in the emergency of nearby hospital or surgeon/ clinician as delay may cause complications 

Diagnosis and investigations 

  1. Routine blood investigations 
  2. X- ray of the abdomen 
  3. Contrast enhanced computerised tomography (CECT) of the abdomen to know the exact cause and site of  obstruction to plan further treatment.

After the diagnosis of intestinal obstruction is confirmed, the treatment depends upon the cause symptoms and condition of the patient for medical or surgical management. Initially patients are give supportive care.

Treatment for intestinal obstruction 

The clinical scenario of the patient mainly determines the need of surgery, usually in cases of partial intestinal obstruction the patients are given trial of supportive management and many patients improve with medications. 

In case of complete intestinal obstruction or where there is determined cause of obstruction which need to removed surgically, the surgery is planned on emergency/ semi emergency basis by surgeon. The conventional open surgery is commonly performed but centres/ surgeons with high expertise can give a trial of laparoscopic surgery. 

Recovery after surgery 

Patients after surgery will require high dependence or intensive care for initial 1-2 days after surgery depending upon the recovery. The hospital stay in these cases vary depending upon the cause, patient and recovery. 

To consult with best team of general and minimal access surgeons available at  The Surgeons House (SHL) in different global locations, please click this link for more details. 

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