mechanical obstruction & non mechanical obstruction
Causes of non-mechanical obstruction
-MOST COMMON: handling of intestines during sx -intestinal function is lost for a few hours or days -may be caused by peritonitis due to leakage of colonic contents- irritation and inflammation -vascular insufficiency- embolus decreases blood flow to the mesenteric blood vessels- severe insufficiency can cause blood infarct
non-mechanical obstruction
paralytic ileus or adynamic ileus peristalsis is decreased or absent d/t neuromuscular disturbances, results in slowing of the movement or backup of bowel contents
Causes of mechanical obstruction
adhesions- scare tissue from sx benign or malignant tumors appendicitis complications hernias fecal impaction structures due to crohns dz or radiation treatment
manifestations of a non mechanical obstruction
abd distention constant, diffuse discomfort decrease in bowel sounds is early absent bowel sounds is late
mechanical obstruction
bowel is physically blocked by problems outside the intestines (adhesions) in the bowel wall (crohns dz) or in the intestinal lumen (tumors)
Causes of mechanical obstruction: fibrosis
due to endometriosis
Causes of mechanical obstruction: vascular dz
emboli and arteriosclerotic narrowing of mesenteric artery
manifestations of a non mechanical obstruction: vomiting
gastric contents bile no foul smell
manifestations of mechanical obstruction
mid abd pain or cramping vomiting- bile, mucus, orange-brown, foul smell obstipation- no passage of gas or stool, in complete obstruction diarrhea- may be present in partial obstruction alteration in bowel pattern and stool abd distention *borborgymi- proxmial high pitched bowel sounds abd tenderness
Causes of mechanical obstruction: intussusception
telescoping segment of intestines within itself
manifestations of a non mechanical obstruction: obstipation
this may or may no be present with a non mechanical obstruction
hypokalemia
this predisposes a patient to a paralytic ileus (non mechanical)
Causes of mechanical obstruction: volvulus
twisting of intestine