Jonny and Ed
Together in Surgery
Video Duration: 22 minutes
SMALL and LARGE bowel obstruction
Simple - one obstructing point
Closed loop - two obstructing points, without vascular compromise
Strangulated - obstruction with vascular compromise
Small bowel obstruction:
Large bowel obstruction
Small bowel obstruction: Usually a patient who has had previous abdominal surgery presenting with vomiting and central, colicky abdominal pain.
Large bowel obstruction: Usually an older patient with abdominal distension and absolute constipation (no flatus or passing of faeces). Vomiting and nausea are not typical features.
Unwell patient. In large bowel obstruction the abdomen will be distended and tympanic.
CT abdomen and pelvis: if the cause is not adhesions then CT may reveal the site/cause of the obstruction.
If a malignant stricture is suspected this will require colonoscopy + biopsy.
Supportive: NBM and NGT (if vomiting)
BO caused by adhesions may resolve spontaneously, however surgery may be required to relieve the obstruction.