Intestinal obstruction occurs when the intestinal contents can not operate normally or pass through.Obstruction may cause abdominal pain, vomiting, abdominal distension, and stop anal exhaust and defecation.Complete intestinal obstruction refers to intestinal obstruction in which the intestinal tube is completely blocked, resulting in the inability of intestinal contents to pass through.The clinical manifestations are generally more obvious and more serious.
TCM disease name
Complete intestinal obstruction
Visiting department
GI Medicine
Common causes
It usually develops from incomplete intestinal obstruction
common symptom
Abdominal colic, abdominal distention, vomiting
infectivity
nothing
Science popularization in China
Committed to authoritative science communication
The certification expert of this term is
Dai Menghua|Chief physician
Basic Surgery Department of Peking Union Medical College Hospitalto examine
It usually develops from incomplete intestinal obstruction
common symptom
Abdominal colic, abdominal distention, vomiting
infectivity
nothing
pathogeny
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It usually develops from incomplete intestinal obstruction.
clinical manifestation
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1. Symptoms
(1) Abdominal pain is characterized by paroxysmal abdominal colic, which starts early and is severe.The onset of abdominal pain may be accompanied by bowel sounds.
(2) In case of abdominal distention and intestinal obstruction, there is obvious accumulation of air and fluid in the intestinal cavity above the obstruction, leading to intestinal expansion.The longer the obstruction time, the more obvious the abdominal distension symptoms.
(3) Generally speaking, the higher the location of obstruction, the more complete the degree of vomiting, the earlier the vomiting occurs, and the more frequent the vomiting occurs.
(4) The intestinal contents cannot pass through the obstruction site after stopping exhaust and defecation. The intestinal tube below the obstruction is empty, which is clinically manifested as stopping exhaust and defecation.
(5) Systemic symptoms: obvious clinical symptoms, such as weak pulse, mental depression, electrolyte disorder and acid-base imbalance, even shock, circulatory failure, etc.
2. Physical signs
(1) Abdominal distention is obvious, intestinal type and gastrointestinal peristaltic wave can be seen.
(2) There is tenderness in the abdomen, drum sound on percussion, high pitched bowel sounds or sound of air flowing through water on auscultation, and high pitched metal sounds can be seen in a large amount of gas accumulation in the intestine.
inspect
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1. Laboratory inspection
White blood cell count, urine specific gravity, etc.
2. X-ray examination
The intestinal loop above the obstruction was significantly inflated, and there was no gas in the intestine below the obstruction.
3. CT examination
It can identify the cause and location of intestinal obstruction.
diagnosis
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The diagnosis can be confirmed according to the medical history, clinical manifestation, laboratory examination and X-ray examination.X-ray examination has important diagnostic value. X-ray examination of complete intestinal obstruction shows that the intestinal loop above the obstruction is significantly inflated and dilated, and there is no gas in the intestine below the obstruction.
differential diagnosis
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This disease should be differentiated from incomplete intestinal obstruction.
1. Complete intestinal obstruction is usually acute, with obvious symptoms and frequent vomiting;Incomplete intestinal obstruction is mostly chronic obstruction, the symptoms are generally not obvious, vomiting and abdominal distention are mild, often intermittent attacks.
2. X-ray plain film shows that there may be gas in the intestinal loop of patients with complete intestinal obstruction, and there is no gas or isolated dilated intestinal loop in the intestinal loop of patients with incomplete intestinal obstruction.
treatment
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1. Non operative treatment
(1) Abstain from eating and drinking, and give patients gastrointestinal decompression to reduce abdominal distension.
(2) Correct the imbalance of water, electrolyte and acid-base balance, and provide nutritional support to patients when necessary.
(3) Use broad-spectrum antibiotics, combined with antibiotics for anaerobic bacteria, for anti infection treatment.
(4) Give patients sedative, analgesic and antispasmodic drugs according to their condition, but the application of analgesics should follow the principle of acute abdomen treatment.
2. Surgical treatment
(1) Surgical treatment is applicable to complete intestinal obstruction caused by non operative treatment failure, congenital intestinal atresia, intestinal tumor, etc.
(2) The surgical methods include exploratory laparotomy, short circuited anastomosis of intestinal loop, enterostomy, etc.
