Large Bowel Obstruction

Posted by e-Medical PPT Monday, November 8, 2010
Bowel obstruction is a mechanical or functional obstruction of the intestines, preventing the normal transit of the products of digestion.Depending on the level of obstruction, bowel obstruction can present with abdominal pain, abdominal distension, vomiting, fecal vomiting, and constipation.Bowel obstruction may be complicated by dehydration and electrolyte abnormalities due to vomiting; respiratory compromise from pressure on the diaphragm by a distended abdomen, or aspiration of vomitus; bowel ischaemia or perforation from prolonged distension.In large bowel obstruction the pain is felt lower in the abdomen and the spasms last longer. Constipation occurs earlier and vomiting may be less prominent.
Ogilvie syndrome is the acute pseudoobstruction and dilation of the colon in the absence of any mechanical obstruction in severely ill patients.Colonic pseudo-obstruction is characterized by massive dilatation of the cecum and right colon on abdominal X-ray.It is a type of megacolon, sometimes referred to as "acute megacolon," to distinguish it from toxic megacolon.Usually the patient has abdominal distention, pain and altered bowel movements.The exact mechanism behind the acute colonic pseudo-obstruction is not known.
Ogilvie's syndrome may occur after surgery, especially following coronary artery bypass surgery and total joint replacement.It is also seen with neurologic disorders, serious infections, cardiorespiratory insufficiency, and metabolic disturbances. Drugs that disturb colonic motility (opioid analgesics) contribute to the development of this condition.

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