Intestinal obstruction etiology

Written by Zhang Peng
General Surgery
Updated on March 02, 2025
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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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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 Xu Jun Hui
General Surgery
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Methods for examining intestinal obstruction

The simplest test for intestinal obstruction is an upright abdominal X-ray, which can diagnose intestinal obstruction if dilated bowel loops and fluid levels are seen. Diagnosis can also be based on the patient's history and physical signs, such as nausea, vomiting, cessation of passing gas or stool, etc. Currently, abdominal CT can also diagnose intestinal obstruction, with the simplest method being the upright abdominal X-ray. Different types of intestinal obstruction require different treatments. For obstructions caused by tumors or volvulus, prompt surgical treatment is necessary. For general intestinal obstructions, such as those caused by adhesions or intestinal dysmotility, the preferred treatment includes fasting, hydration, anti-inflammatory medications, and other supportive measures. For elderly patients with obstipation-induced obstruction, enema treatment can be initiated first.

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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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General Surgery
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How long to fast for intestinal obstruction

Intestinal obstruction and the barrier to the passage of intestinal contents can lead to intestinal obstruction, typically characterized by abdominal pain, bloating, cessation of passing gas and stools, and in cases of high intestinal obstruction, it may also involve nausea and vomiting. How long fasting should be continued in the case of intestinal obstruction depends on whether the patient has resumed passing gas and stools, as well as whether symptoms such as abdominal pain, bloating, nausea, and vomiting have subsided. If the patient's abdominal pain and bloating have mostly subsided, passing gas and stools have resumed, and there is no bloody stool or symptoms of nausea and vomiting, then a gradual reintroduction of a liquid diet can be started. If abdominal pain and bloating do not worsen, and there is passing gas and stools, then a transition to a semi-liquid diet until a normal diet is resumed can be made. Therefore, the duration of fasting for intestinal obstruction should be determined based on the effectiveness of the treatment for the obstruction.

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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.