How to deal with intestinal obstruction?

Written by Li Jin Quan
General Surgery
Updated on September 14, 2024
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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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Early symptoms of intestinal obstruction

What are the early symptoms of intestinal obstruction? For intestinal obstruction, the symptoms that appear in the early stages vary depending on the location of the obstruction. If it is a high-level obstruction, the main early symptoms are nausea and vomiting. If it is a low-level obstruction, abdominal distension is more prominent early on, and nausea and vomiting are less common. Additionally, the cause of the obstruction also leads to different symptoms. For instance, if the obstruction is simply due to adhesions in the abdominal cavity, the early symptoms may include poor appetite or nausea and vomiting. If it is caused by tumors in the digestive tract, early symptoms might include abdominal bloating, difficulty defecating, bloody stools, or changes in the characteristics of the stool, among others.

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General Surgery
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Intestinal obstruction etiology

What are the causes of intestinal obstruction? Generally, in clinical practice, the causes and inducements of intestinal obstructions are mainly divided into the following aspects: Firstly, there are extraintestinal disorders, such as some space-occupying lesions in the abdominal cavity compressing the intestinal tube, causing narrowing of the intestinal lumen and thus obstruction. Additionally, there are diseases of the intestines themselves. Some severe intestinal diseases or tumorous conditions, or ischemic diseases of the intestines themselves, can all potentially lead to intestinal obstruction. If the symptoms of intestinal obstruction are typical, hospital treatment and possibly surgery may be necessary. Furthermore, some motility factors within the abdominal cavity can also cause intestinal obstruction, such as a reduction in the motility of the intestines or paralysis and expansion of the intestines due to electrolyte disturbances, leading to symptoms of intestinal obstruction.

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General Surgery
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How to check for intestinal obstruction?

Generally, after the occurrence of intestinal obstruction, patients typically exhibit classic symptoms such as abdominal pain, bloating, vomiting, and cessation of passing gas or stool. If this happens, the most routine hospital examination includes abdominal ultrasonography and plain abdominal radiographs. When necessary, during the treatment process, a more comprehensive abdominal enhanced CT may be needed, or even gastroscopy and colonoscopy, because identifying the cause of the intestinal obstruction is crucial for treatment. Addressing the cause can reduce the frequency of future intestinal obstructions. For adhesive obstructions caused by abdominal surgery, lifestyle and dietary habits are extremely important. Since adhesive obstructions cannot be completely resolved through surgery, adjustments in diet or lifestyle and behavior are essential to minimize recurrence.

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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
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How is intestinal obstruction diagnosed?

The main clinical manifestations of intestinal obstruction include abdominal pain, abdominal distension, vomiting, and cessation of gas and bowel movements from the anus. During the physical examination, tenderness in the abdomen can be observed, as well as hyperactive bowel sounds. Laboratory tests may reveal increased red and white blood cell counts, and electrolyte imbalances. Supplementary examinations, such as abdominal X-ray films, can show dilation of the intestinal tube, air and fluid accumulation within the abdominal cavity, and the presence of fluid-air levels. Abdominal ultrasound can also reveal air and fluid accumulation in the intestinal tube. Through the above examinations, intestinal obstruction can be diagnosed.