Intestinal obstruction in Hindi- Definition, Cause, Symptom, Investigation, T/t Dr.Shipra Mishra

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Intestinal obstruction- The Intestinal contents are obstructed to travel from the Proximal part to Distal part.
Congenital- Intestinal atresia, Congenital megacolon etc.
Acquired- Hernia, Intussusception

Classification-
1- Acc. Nature of Obstruction- Dynamic- Peristalsis working
Adynamic- (-)ve moving
2- Acc. To blood supply- Simple obstruction- 90%
Strangulation- 10%
3- Acc. Cause of Obstruction-
Intra-luminal- Gallbladder, Roundworms, Faeces etc.
Intra-mural- tuberculosis, stricture, Malignancy etc.
Extra-luminal- Adhesion, Hernia, Volvulus, intussusception etc.

Symptoms-
Abdominal pain(cramps- relives after (5-10 min)-Central-SI
Peripheral- LI
Vomiting/ Nausea- early in high small bowel obs, absent in LO
Abdominal distension-Central(epigastric & hypogastric)-SI
Peripheral- LI
Constipation- early in large bowel obs
Obstipation

Signs-
Dehydration
Blumberg's Signs(Rebound tenderness)
Rigidity of abdominal muscle
Absence of bowel sound (not in early stage)
Tachycardia
Fever

Complication-
Bowel ischemia- due to venous compression
Perforation- due to distension
Sepsis- due to perforation

Investigation-
CBC
Serum electrolyte
Barium meal shows FB
Plain abdominal X-rays- supine & upright view
USG abdomen
2 enema test-
After 1st enema- faces
After 2nd enema- no faces

Treatment-
Conservative-
Resuscitation- NG tube for decompression
BP normal
Fluid therapy
NBM
Antiemetics
Antipyretics
NSAIDS
Surgical Management-
Indication-
If no resolution after 72 hours
When complete blockage of the bowels
Malignancy
Perforation
Strangulation
Gangrene

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