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16 Cards in this Set

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Name four common causes of small bowel obstruction.
1) Adhesions

Also, hernias, cancer, Crohn's disease.

The ABCs of small bowel obstruction:

A - adhesions
B - bulges (hernias)
C - cancer, Crohn's
What are the symptoms and signs of small bowel obstruction?
Symptoms:

1) Colicky abdominal pain
2) Nausea/vomiting
3) Constipation

Signs:

High frequency bowel sounds
Distention
What MUST you look for on physical exam for small bowel obstruction?
Hernias

Digital rectal examination.
How can SBO be distinguished from ileus?
Bowel obstruction displays a transition point between dilated proximal bowel and normal-caliber distal bowel, while ileus is just diffusely distended.
What are the symptoms of small bowel obstruction?
1) Crampy, colicky abdominal pain.

2) Nausea and bilious vomiting

3) Constipation
What are the signs of small bowel obstruction?
High-pitched bowel sounds, tenderness, distention.
Which acid/base, electrolyte, and fluid disturbances are classically associated with proximal obstruction?
Hypovolemia
Alkalosis
Hypokalemia
You're doing a physical exam on somebody for possible SBO. What MUST you look for that you could forget.
HERNIAS (check groin)

Also, as always, do a DRE so as to check for blood.
What radiographic studies might you order for someone with suspected SBO?
The so-called "abdominal series"
-consists of supine AXR, upright AXR, and upright CXR
-distended loops of bowel (>3 cm)
-air-fluid levels

Small-bowel follow-through
CT with oral contrast
Into what groups can all small bowel obstructions be divided into?
Partial and complete
Name some potential complications of small bowel obstruction.
Strangulation and necrosis
Fluid, electrolyte, and acid-base disturbances
?Perforation?
What is the treatment of someone with complete small bowel obstruction?
Laparotomy with lysis of adhesions
What is the treatment of someone with partial small bowel obstruction?
Conservative treatment (resuscitation, monitoring, NGT compression)
A patient has flatus and bowel movements. Can they have a small bowel obstruction?
Yes; the bowel distal to the obstruction can clear out gas and stool.
What are the signs of strangulated bowel?
Fever
Shock
Peritoneal signs
Acidosis (from lactic acid)
What condition commonly mimics SBO?
Paralytic ileus