Download What is your diagnosis now? Other considerations? Bases?

What is your diagnosis now?
Other considerations? Bases?
SMALL BOWEL OBSTRUCTION
•
•
•
•
Abdominal pain. Most small-bowel obstructions cause waves of cramping
abdominal pain. The pain occurs around the belly button (periumbilical area). If an
obstruction goes on for a while, the pain may decrease because the bowel stops
contracting. Continuous severe pain in one area can mean that the blockage has
cut off the bowel's blood supply. This is called a bowel strangulation and requires
emergency treatment.
Vomiting. Small-bowel obstructions usually cause vomiting. The vomit is usually
green if the obstruction is in the upper small intestine and brown if it is in the
lower small intestine.
Elimination problems. Constipation and inability to pass gas are common signs of
a bowel obstruction. However, when the bowel is partially blocked, you may have
diarrhea and pass some gas. If you have a complete obstruction, you may have a
bowel movement if there is stool below the obstruction.
Bloating. Blockages may cause bloating in the lower abdomen. You may also hear
gurgling sounds coming from your belly. With a complete obstruction, your doctor
may hear high-pitched sounds when listening with a stethoscope. The sounds
decrease as movement of the bowel slows
SMALL BOWEL OBSTRUCTION
• In small bowel obstruction the pain tends to
be colicky (cramping and intermittent) in
nature, with spasms lasting a few minutes.
The pain tends to be central and midabdominal. Vomiting occurs before
constipation
• Depending on the level of obstruction, bowel
obstruction can present with abdominal pain,
abdominal distension, vomiting, fecal
vomiting, and constipation.
• Obstruction may be due to causes within the
bowel lumen, within the wall of the bowel, or
external to the bowel (such as compression,
entrapment or volvulus).
OTHER CONSIDERATIONS
LARGE BOWEL OBSTRUCTION
• In the large intestine, obstructions are most
often caused by cancer
• . Other causes are severe constipation from a
hard mass of stool and twisting or narrowing
of the intestine that may occur because of
diverticulitis or inflammatory bowel disease
LARGE BOWEL OBSTRUCTION
Symptoms of large-bowel obstruction can include:
• A bloated abdomen
• Abdominal pain, which can be either vague and mild, or sharp and
severe, depending on the cause of the obstruction
• Constipation at the time of obstruction, and possibly intermittent
bouts of constipation for several months beforehand
• If a colon tumor is the cause of the problem, a history of rectal
bleeding (such as streaks of blood on the stool)
• Diarrhea resulting from liquid stool leaking around a partial
obstruction
• Blockages caused by cancer may cause symptoms such as blood in
the stool, weakness, weight loss, and lack of appetite.
COLON CANCER
• � About half of all large-bowel obstructions
are caused by colorectal cancer. Undiagnosed
colon or rectal cancer may cause a gradual
narrowing of the large intestine's inner
passageway. Usually patients experience
intermittent constipation for a while before
the bowel finally becomes obstructed.
• The symptoms of colorectal cancer depend on
the location of tumor in bowel and whether it
has spread to elsewhere in the body
(metastasis).
• Symptoms and signs are divided into local,
constitutional (affecting the whole body) and
metastatic (caused by spread to other organs).
LOCAL
• tumor that is large enough to fill the entire lumen of the
bowel may cause bowel obstruction. This situation is
characterized by constipation, abdominal pain, abdominal
distension and vomiting as seen in the patient
CONSTITUTIONAL
• If a tumor has caused chronic occult bleeding, iron
deficiency anemia may occur; this may be experienced as
fatigue, palpitations and noticed as pallor (pale appearance
of the skin). Colorectal cancer may also lead to weight loss
generally due to a decreased appetite
METASTATIC
• Colorectal cancer most commonly spreads to the
liver.
• This may go unnoticed, but large deposits in the
liver may cause jaundice and abdominal pain
(due to stretching of the capsule).
• If the tumor deposit obstructs the bile duct, the
jaundice may be accompanied by other features
of biliary obstruction, such as pale stools.