Monday, November 15, 2010

Bowel Obstruction

Small bowel obstruction

Large bowel obstruction



* the four cardinal symptoms of bowel obstruction are:

- vomiting

- colicky abdominal pain

- constipation

- abdominal distension

Less distension, vomiting occurs earlier, pain is higher in the abdomen

More distension, vomiting occurs later and feculent, pain is lower in the abdomen

Radiologic features

Small bowel features:

Valvulae conniventes – folds that cross the lumen completely

Normal features of small bowel:
- No more than 3 mm wall thickness
- Generally no more than 3 air fluid levels
- No more than 3 cm diameter

Large bowel features:

Haustrations: incomplete crossing of folds across the lumen

3,6,9 rule

Maximal normal diameter in small bowel 3 cm

Maximal normal diameter in large bowel 6 cm

Maximal normal diameter in cecum 9 cm

In colorectal Carcinoma

Left sided tumors: generally presented with altered bowel habit, blood or mucus PR, mass PR

Right sided tumors: generally presented with weight loss, anemia, less obstructive symptoms

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