Intestinal obstruction symptoms and treatment

Intestinal obstruction is a manifestation of certain abnormalities in our intestines. It is an abdominal disease. This disease should be treated promptly after it occurs, and its symptoms are somewhat different from other intestinal diseases. However, many people do not know what its symptoms and treatments are. So what are the symptoms and treatments of intestinal obstruction?

Any obstruction in the passage of intestinal contents caused by any reason is collectively called intestinal obstruction. It is one of the common surgical emergencies. Sometimes acute intestinal obstruction is difficult to diagnose, the disease progresses rapidly, and often leads to death. Imbalance of water, electrolytes and acid-base, as well as the patient's advanced age and combined cardiopulmonary insufficiency are often the causes of death.

Clinical manifestations 1. Adhesive intestinal obstruction

Symptoms: ( 1) A history of chronic obstructive symptoms and repeated acute attacks.

(2) Most patients have a history of abdominal surgery, trauma, bleeding, foreign bodies, or inflammatory diseases.

(3) Clinical symptoms include paroxysmal abdominal pain, accompanied by nausea, vomiting, abdominal distension, and cessation of flatulence and defecation.

Physical examination: (1) General condition: There are usually no obvious changes in the early stages of obstruction, but signs of fluid loss may appear in the late stages. When strangulation occurs, systemic poisoning symptoms and shock may occur.

(2) The following situations should be noted during abdominal examination: ① Those with a history of abdominal surgery may have scars from the abdominal wall incision; ② Patients may have abdominal distension, which is often asymmetrical; ③ Intestinal patterns and peristaltic waves may be seen in most cases; ④ Abdominal tenderness is often not obvious in the early stages, but may become obvious as the disease progresses; ⑤ A tender mass may be palpated when the obstructed intestinal loop is relatively fixed; ⑥ Patients with increased peritoneal fluid or intestinal strangulation may have peritoneal irritation signs or shifting dullness; ⑦ Before intestinal obstruction develops into intestinal strangulation or intestinal paralysis, bowel sounds become hyperactive, and the sound of air passing through water or metallic sounds may be heard.

2. Strangulated intestinal obstruction

Symptoms: (1) Abdominal pain is persistent and severe, with frequent paroxysmal aggravation and no complete rest. Vomiting cannot relieve the abdominal pain and bloating.

(2) Vomiting occurs early and is more frequent.

(3) Systemic changes occur early, such as increased pulse rate, increased body temperature, increased white blood cell count, or a tendency to shock at an early stage.

(4) Abdominal distension: Low-positioned small bowel obstruction causes obvious abdominal distension, while closed-loop small bowel obstruction causes asymmetric abdominal distension. An isolated swollen large intestinal loop may be palpable, and there is no gas or bowel movement.

(5) Continuous observation: Symptoms of infectious shock such as increased body temperature, increased pulse, decreased blood pressure, and impaired consciousness may be detected, and bowel sounds may change from hyperactive to weakened.

(6) Obvious signs of peritoneal irritation.

(7) The vomitus is bloody or bloody liquid is discharged from the anus.

(8) Abdominal puncture revealed bloody fluid.

Treatment 1. Adhesive intestinal obstruction

(1) Non-surgical treatment is generally used for simple and incomplete intestinal obstruction, especially for those with extensive adhesions. For simple intestinal obstruction, observation can be performed for 24 to 48 hours. For strangulated intestinal obstruction, surgical treatment should be performed as soon as possible. Generally, observation should not exceed 4 to 6 hours.

Basic therapy includes fasting and gastrointestinal decompression, correction of water, electrolyte and acid-base imbalances, and prevention and treatment of infection and septicemia.

(2) Surgical treatment: If the condition of adhesive intestinal obstruction does not improve or worsens after non-surgical treatment; or if strangulated intestinal obstruction, especially closed loop intestinal obstruction, is suspected; or if adhesive intestinal obstruction recurs frequently and seriously affects the patient's quality of life, surgical treatment should be considered. ① The adhesive tape or small pieces of adhesive are simply cut and separated. ② If the intestinal loops are tightly adhered in a small area and cannot be separated, or the intestinal tract is necrotic, intestinal resection and anastomosis can be performed. If the intestinal edema is obvious, the primary anastomosis is difficult, or the patient's condition is poor during the operation, a fistula can be performed first. ③If the patient’s condition is extremely poor or blood pressure is difficult to maintain during surgery, enteral externalization can be performed first. ④ If the intestinal loops are tightly adhered and cannot be removed or separated, side-to-side anastomosis of the distal and proximal intestinal tracts at the obstruction site can be performed. ⑤ Intestinal arrangement surgery can be performed for patients with extensive adhesions and recurrent intestinal obstruction.

2. Strangulated intestinal obstruction

(1) Strangulated small intestinal obstruction should be treated surgically immediately once diagnosed, and the surgical method should be determined based on the cause of strangulation.

(2) If the patient's condition is extremely serious, the intestinal tract has been necrotic, and the blood pressure cannot be maintained during the operation, intestinal externalization can be performed, and a secondary anastomosis can be performed after the patient's condition improves.