Makindo Medical Notes"One small step for man, one large step for Makindo" |
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Related Subjects: Small Bowel Obstruction |Colonic (Large bowel) Obstruction |Caecal Volvulus |Small Bowel Ischemia |Hartmann's procedure |Sigmoid Volvulus |Acute Colonic Pseudo-obstruction |
🚨 Small Bowel Obstruction (SBO) is a surgical emergency. It most often arises from adhesions after previous laparotomy, but can also result from hernia, Crohn’s disease, or intussusception. ⚠️ Diagnosis is often delayed, leading to perforation, sepsis, and high mortality if not recognised early.
🩺 Initial Management of SBO |
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The valvulae conniventes are clearly demonstrated. Central distended small bowel loops with visible old surgical staples. Cause: adhesions.
Feature | Small Bowel | Large Bowel |
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Abdominal Pain | Early, colicky, central | Dull, less colicky |
Vomiting | Early bilious, late faeculent | Occurs later |
Constipation | Late feature | Early, may pass diarrhoea if partial |
Distension | Less if high obstruction; marked if distal | Marked, esp. sigmoid/caecal volvulus |
Bowel Sounds | High-pitched "tinkling" | Often reduced or absent late |
AXR | Central dilated loops, valvulae conniventes across bowel | Peripheral dilatation, haustra not spanning full lumen |
Common Causes | Adhesions, hernia, Crohn’s, volvulus | Colorectal cancer, sigmoid volvulus, diverticular disease |