OTHER LESS COMMON CAUSES OF OBSTRUCTION

1. Volvulus – a twisting or folding over onto itself ( Small intestine) like a balloon artist with the long thing balloons.

• Closed Loop = High Grade

• Open Loop = Low Grade

• Volvulus is seen in premature infants.

• If there is an adhesion anchoring the bowels it causes a pivot point allowing for twisting.

2. Intusseception – is a telescoping or invagination

   • The most common cause of this in adults is a tumor!!!

3. Perforation – is the worst case scenario of obstruction as it leads to peritonitis.

4. Functional Obstruction (a.k.a. Adynamic Ileus, Paralytic Ileus)

• Whereas other obstructions maintain intact neurological tracts Functional Obstructions have inhibited motor function.

• Any “itis” in the abdomen can cause decreased motor function (i.e. Cholecystitis, Meckel’s diverticulitis, hepatitis, appendicitis, peritonitis.

• KUB is usually normal

• Bolus clears in a Functional Obstruction because of the work of more proximal parts of the Small Intestine.

• The area of functional obstruction just does not contract

• Functional obstruction can cause severe back pain

• Surgery can produce Functional Obstruction

• If an ITIS caused it take care of the IT IS!

• If back pain is decreased function is restored.

Category: Gastroenterology Notes