Disease: Intestinal obstruction

Overview

Intestinal obstruction is a blockage that keeps food or liquid from passing through your small intestine or large intestine (colon). Causes of intestinal obstruction may include fibrous bands of tissue (adhesions) in the abdomen that form after surgery, an inflamed intestine (Crohn's disease), infected pouches in your intestine (diverticulitis), hernias and colon cancer.

Without treatment, the blocked parts of the intestine can die, leading to serious problems. However, with prompt medical care, intestinal obstruction often can be successfully treated.

Source: http://www.mayoclinic.com

Symptoms

Signs and symptoms of intestinal obstruction include:

  • Crampy abdominal pain that comes and goes
  • Loss of appetite
  • Constipation
  • Vomiting
  • Inability to have a bowel movement or pass gas
  • Swelling of the abdomen

When to see a doctor

Because of the serious complications that can develop from intestinal obstruction, seek immediate medical care if you have severe abdominal pain or other symptoms of intestinal obstruction.

Source: http://www.mayoclinic.com

Causes

The most common causes of intestinal obstruction in adults are:

  • Intestinal adhesions — bands of fibrous tissue in the abdominal cavity that can form after abdominal or pelvic surgery
  • Colon cancer

In children, the most common cause of intestinal obstruction is telescoping of the intestine (intussusception).

Other possible causes of intestinal obstruction include:

  • Hernias — portions of intestine that protrude into another part of your body
  • Inflammatory bowel diseases, such as Crohn's disease
  • Diverticulitis — a condition in which small, bulging pouches (diverticula) in the digestive tract become inflamed or infected
  • Twisting of the colon (volvulus)
  • Impacted feces

Pseudo-obstruction

Intestinal pseudo-obstruction (paralytic ileus) can cause signs and symptoms of intestinal obstruction, but doesn't involve a physical blockage. In paralytic ileus, muscle or nerve problems disrupt the normal coordinated muscle contractions of the intestines, slowing or stopping the movement of food and fluid through the digestive system.

Paralytic ileus can affect any part of the intestine. Causes can include:

  • Abdominal or pelvic surgery
  • Infection
  • Certain medications that affect muscles and nerves, including tricyclic antidepressants, such as amitriptyline  and imipramine (Tofranil), and opioid pain medications, such as those containing hydrocodone (Vicodin) and oxycodone (Oxycontin)
  • Muscle and nerve disorders, such as Parkinson's disease

Source: http://www.mayoclinic.com

Diagnosis

Tests and procedures used to diagnose intestinal obstruction include:

  • Physical exam. Your doctor will ask about your medical history and your symptoms. He or she will also do a physical exam to assess your situation. The doctor may suspect intestinal obstruction if your abdomen is swollen or tender or if there's a lump in your abdomen. He or she may listen for bowel sounds with a stethoscope.
  • X-ray. To confirm a diagnosis of intestinal obstruction, your doctor may recommend an abdominal X-ray. However, some intestinal obstructions can't be seen using standard X-rays.
  • Computerized tomography (CT). A CT scan combines a series of X-ray images taken from different angles to produce cross-sectional images. These images are more detailed than a standard X-ray, and are more likely to show an intestinal obstruction.
  • Ultrasound. When an intestinal obstruction occurs in children, ultrasound is often the preferred type of imaging. In youngsters with an intussusception, an ultrasound will typically show a "bull's-eye," representing the intestine coiled within the intestine.
  • Air or barium enema. An air or barium enema is basically enhanced imaging of the colon that may be done for certain suspected causes of obstruction. During the procedure, the doctor will insert air or liquid barium into the colon through the rectum. For intussusception in children, an air or barium enema can actually fix the problem most of the time, and no further treatment is needed.

Source: http://www.mayoclinic.com

Complications

Untreated, intestinal obstruction can cause serious, life-threatening complications, including:

  • Tissue death. Intestinal obstruction can cut off the blood supply to part of your intestine. Lack of blood causes the intestinal wall to die. Tissue death can result in a tear (perforation) in the intestinal wall, which can lead to infection.
  • Infection. Peritonitis is the medical term for infection in the abdominal cavity. It's a life-threatening condition that requires immediate medical and often surgical attention.

Source: http://www.mayoclinic.com

Risk factors

Diseases and conditions that can increase your risk of intestinal obstruction include:

  • Abdominal or pelvic surgery, which often causes adhesions — a common intestinal obstruction
  • Crohn's disease, which can cause the intestine's walls to thicken, narrowing the passageway
  • Cancer in your abdomen, especially if you've had surgery to remove an abdominal tumor or radiation therapy

Source: http://www.mayoclinic.com

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