Intestinal obstruction

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Written by Zhang Peng
General Surgery
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How to diagnose intestinal obstruction?

How to diagnose intestinal obstruction, which is a common acute abdomen condition in surgery. If symptoms such as cessation of passing gas or stools, abdominal pain, and vomiting occur, it may suggest the presence of an intestinal obstruction. The simplest diagnostic method for intestinal obstruction is to perform an upright abdominal plain film to assess the degree of obstruction, based on the presence or absence of fluid levels. Furthermore, identifying the fundamental cause of the obstruction is essential; this can be achieved through enhanced abdominal CT and colonoscopy to make a determination. An abdominal ultrasound can also be performed, which provides a better understanding of the condition of the intestinal obstruction. Using abdominal ultrasound, the presence of effusion can be detected, and by aspirating the effusion, its properties can be analyzed to determine if there is a condition such as bowel necrosis.

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Written by Zhang Peng
General Surgery
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How to relieve intestinal obstruction

How to alleviate intestinal obstruction, which means how to treat intestinal obstruction. After the occurrence of intestinal obstruction, it is first important to clarify what intestinal obstruction is. Intestinal obstruction is characterized by cessation of gas and stool passage from the anus, and is usually accompanied by symptoms such as abdominal distension, nausea, vomiting, and even fever. If intestinal obstruction occurs, firstly, do not eat or drink, and then carry out appropriate examinations to identify the cause of the obstruction. If it is adhesive obstruction, treatment generally includes fasting, gastrointestinal decompression, anti-inflammatory treatment, fluid replenishment, and enemas as symptomatic treatment measures, trying to keep the treatment as conservative as possible. If the obstruction is caused by a tumor, it is preferable to perform surgery to remove the obstruction based on a clear diagnosis, as this is the only effective treatment.

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Written by Zhang Peng
General Surgery
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Principles of Intestinal Obstruction Treatment

In the treatment principles of intestinal obstruction, the basic treatment methods apply to both partial and complete intestinal obstructions. Firstly, gastrointestinal decompression is required based on the situation. Gastrointestinal decompression involves the insertion of a gastric tube, which is determined by whether the patient has symptoms of nausea and vomiting. If these symptoms are prominent, a gastric tube should be placed to drain the stomach contents, thus alleviating the burden and swelling of the intestines and aiding in the treatment of the disease. Another aspect is fluid replenishment and anti-inflammation, as intestinal obstruction will definitely lead to changes in intestinal flora and concurrent infections, making anti-infection measures very important. Fluid replenishment involves administering nutrient solutions to provide nutrition and prevent electrolyte imbalances. Additionally, enemas or traditional Chinese medicine may be used to facilitate intestinal motility. During this treatment process, it is crucial to closely monitor the condition to assess if exploratory surgery is indicated. As the condition can either improve or worsen, close observation is extremely important.

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Written by Zhang Peng
General Surgery
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Intestinal Obstruction Nursing Measures

Intestinal obstruction is primarily a disease that requires treatment, which involves fasting from water, gastrointestinal decompression, anti-inflammation treatments, enemas, and sometimes the auxiliary use of traditional Chinese medicine. The nursing measures for this condition build upon these treatments and involve further management of daily activities. Generally, patients with intestinal obstruction must be cautious with their diet to avoid overeating or consuming foods that are hard to digest or that could potentially form obstructions. Secondly, it is important to manage and ensure that patients avoid vigorous exercise, as such activity can lead to the recurrence of intestinal obstruction, especially if there are adhesions within the abdominal cavity.

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Written by Li Jin Quan
General Surgery
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How to deal with intestinal obstruction?

Patients with intestinal obstruction commonly present with abdominal pain, bloating, vomiting, and cessation of passing gas or stool. Treatment for intestinal obstruction primarily includes conservative management and surgical intervention. Conservative treatment firstly involves gastrointestinal decompression, abstaining from food and drink, and, if necessary, the insertion of a gastric tube. The second step is to enhance anti-inflammatory measures to prevent infections within the abdominal cavity. The third step is proactive fluid replenishment to prevent disorders of water and electrolyte balance. Along with aggressive conservative treatment, the patient's overall condition should be monitored. If a pseudo-obstruction occurs, surgical treatment should be actively pursued.

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Written by Zhang Peng
General Surgery
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Enema method for intestinal obstruction

Enemas are an effective treatment measure in the management of intestinal obstruction. An enema involves a nurse using an enema bag to introduce about 500 milliliters of soapy water through a rounded-tip catheter into the rectum via the anus. Typically, the catheter is inserted about 30 centimeters deep. The purpose of injecting soapy water into the rectum is to stimulate intestinal peristalsis, leading to the expulsion of intestinal contents. During this process, it is important to avoid damage to the intestinal mucosa and consider the patient's tolerance. Generally, it is preferable to retain the soapy water for an extended period for better results.

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Written by Li Jin Quan
General Surgery
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How is intestinal obstruction treated?

Patients with intestinal obstruction primarily receive the following treatments: First, basic treatment, which includes gastrointestinal decompression, where patients need to refrain from eating and drinking, meaning they cannot consume food or water. Additionally, a gastric tube may be inserted. Second, frequent vomiting combined with the prohibition of food and drink can lead to disturbances in electrolyte and acid-base balance, so intravenous fluid supplementation is used to correct these imbalances. Third, appropriate antibiotics are used to prevent infection. Further, in cases of intestinal obstruction, abdominal distension can cause a sensation of bloating in the stomach, and somatostatin may be used to reduce the secretion of gastrointestinal fluids and alleviate abdominal distension. Alongside basic treatment, it’s essential to monitor the abdominal condition to see if it worsens, and surgical intervention should be considered when necessary.

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Written by Li Jin Quan
General Surgery
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Is intestinal obstruction serious?

When the contents of the intestine cannot be normally expelled through the intestinal tract, it is called intestinal obstruction. Its clinical manifestations mainly include abdominal pain, bloating, vomiting, cessation of defecation and flatulence from the anus. The treatment of intestinal obstruction mainly includes conservative treatment and surgical treatment, with the vast majority of patients receiving conservative treatment. This includes gastrointestinal decompression, abstinence from drinking and eating, enhanced anti-inflammatory therapy, and maintenance of electrolyte balance. Only a small portion of patients require surgical treatment. After treatment, the vast majority of patients with intestinal obstruction can recover normally, which means that intestinal obstruction is not a very serious illness.

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Written by Li Jin Quan
General Surgery
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Symptoms of intestinal obstruction

Intestinal obstruction is caused by any factor that causes blockage of the intestinal tube. Compression and twisting cause the intestinal contents to not pass normally, leading to obstructive symptoms. Clinically, intestinal obstruction mainly presents with four major symptoms: first, intermittent abdominal pain; second, vomiting, where the higher the location of the obstruction, the earlier and more frequent the vomiting, consisting mainly of food or gastric fluid. If the location of the obstruction is lower, the vomiting is delayed and less frequent and may include fecal matter; third, abdominal distension, which generally occurs after the obstruction has been present for some time, and its severity is related to the location of the obstruction; fourth, cessation of gas and feces discharge through the anus.

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Written by Zhang Peng
General Surgery
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Does intestinal obstruction cause fever?

It is possible, as the primary pathophysiological change in intestinal obstruction is the translocation of intestinal flora causing infection, which can lead to symptoms such as fever. Therefore, fever is also a factor in assessing the condition. If a patient has persistent high fever, they may even develop septic shock, which could necessitate surgical intervention such as exploratory laparotomy. Thus, fever is a common factor in intestinal obstruction, but it is not a mandatory one.