ILEUS OBSTRUCTIVE

Dr.H.Yuzar Harun,SpB.FinaCs.
Bagian Bedah/SMF RSAM.
Bandar Lampung

Obstruction of the Small Intestine.

Complete proximal obstruction:
Vomiting.
Abdominal discomfort.
Abdominal oral contrast x ray

Complete mid or distal obstruction:

Colicky abdominal pain.
Vomiting.
Abdominal distention.
Constipation-obstipation.
Peristaltic rushes.
Dilated small bowel on x ray

Klasifikasi/Pengertian/Batasan:
Mechanical obstruction(complete or
partial).
Simple obstruction(oklusi lumen).
Strangulation obstruction(gangguan
aliran darah terjadi necrosis.)
Closed loop obstruction( Volvulus).
Paralytic ileus(adynamic ileus)

ETIOLOGI.
Adhesi(post operasi,congenital
band,inflamasi.)
Neoplasma(intrinsik dan ekstrinsik
lumen)
Hernia incarcerata.
Intussusception(Invaginasi).
Volvulus.
Foreign bodies.
Gallstone ileus.
Inflamatory bowel disease.
Stricture.
Cystic fibrisis.
Hematoma

 Pathophysiology.
Gangguan aliran gas dan
cairanDilatasi&distensi
lumenterjadi Squestrasi cairan
dari ekstraseluler spase ke
intralumen & cavum peritoneal
hypovolemia.
Terjadi Fermentasi
BakteriMediator
substances(endotoksin,prostaglan
din)
Masuk ke sirkulasi & sistim
lymfatikSeptic shock.

Pemeriksaan Laboratorium.
Early stagenormal
laboratorium.
Progressive stage terjadi
Hemokonsentrasi,leukositosis,e
lektrolit abnormal,serum
amylase meningkat.

Imaging studies.
Foto polos Abdomen 3
posisi(Supine,LLD,erect)ladde
r-like pattern.

OBSTRUCTION OF THE LARGE

INTESTINE.
Constipation or obstipation.
Abdominal pain.
Nausea and vomiting(late).
Characteristic x ray finding.

Etiologi:
Carcinoma colon
Diverticulitis
Volvulus
Lain2

65%.
20%.
5%.
10%.

Symptoms and Signs

Simple mechanical obstruction.
Pain.
Konstipasi dan obstipasi(Obstruksi
komplit).
Vomiting(ileocecal valve
reflux)Feculent(late manifestation).
Pemeriksaan fisik(abdominal
distensi,tympany,peristaltic wave pada
dinding abdomen,High-pitched,metalic
tinkles).
Pemeriksaan Rectal toucher.

Procedure Diagnostic.

Manifestasi Klinis.
Tumor marker(CEA).
Barium enema.
Colonoscopy.

Treatment.
1.Dekompressi.
2.Obstructing lesion of right
colon One Stage.
3.Obstructing lesion of the left
colontwo-stage procedure.