Bowel Obstruction


Bowel Obstruction


Small bowel obstruction
Large bowel obstruction
Clinical


Symptoms
* 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

Comments

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