Intestinal obstruction

LUTHFIYYA SYAFIQA TAHANY

20180410088
Introduction
 ILEUS :
A condition when there is a passage disruption
 Mechanical Ileus :
The situation where the contens of lumen gastrointestinal cant be distributed to distal
because of obstruction caused abnormality in lumen of intestine, the wall of the intestine or
outer the intestine that pressing or there is abnormality vascularitation at segmen of intestine
that can cause necrosis
Classification
ILEUS

Functional obstruction
(paralytic) (Mechanical)

extent location

strangulation partial high low

simple
Etiology
INTRALUMINAL INTRAMURAL EXTRAMURAL

• Impaction • Congenital • Bands/adhesion

• Foreign bodies atresia • Hernia
• Gallstone • Stricture • Volvulus
• Malignancy • Intussusception
• Tumor
benign/malignant
Pathophysiology
Proximal bowel
dilatedn& Distal to Dehydration &
develops altered Distention is by gas electrolyte loss :
observation bowel and fluid
motility -> dilated - exhibits normal reduced oral
> reduce peristaltic peristaltic & Gas : aerobic and intake, defective
strength -> absorbtion anaerobic growth intestinal
flaccidity & Fluid : digestive absorbtion, loses
paralysis ( pre. -> become empty - from vomiting &
> contract & juices & retarded
Vascular damage absorbtion sequeteration in
due to intraluminal become immobile bowel of lumen
pressure
Clinical manifestation
4 cardinal symptoms :
1. abdominal pain
2. Vomiting
3. Distention
4. Difficulty to flatus and defecation
How to diagnose ?
 Anamesis
4 cardinal symptoms
Location and characteristic of pain ?
 physical exam
1. Inspection
dehydration sign ( turgor skin, mouth and tounge dry)
abdominal distention, heria, scars, and abdominal mass
darm countur
darm steifung
2. Palpation and percussion
◦ Mass, tenderness, distention
◦ Tympani and dullness

3. Auscultation
Bowel sound are high pitch and increase in frequency
Or silent
Radiology

Hearing Bone Appearance Coiled Spring Multiple air fluid level – step ladder appearance
Management
1. rehidration
Isotonic salin fluid , ex : Ringer Lactat
2. DC ( dower kateter )
3. NGT
3. antibiotic broad spectrum
4. surgery