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11 Cards in this Set
- Front
- Back
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What are the three most common causes of small bowel obstruction in adult?
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1) Adhesions (65%)
2) External hernia (15%) 3) Neoplasm (15%) |
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What are they in the colon?
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1) Colon CA (65%)
2) Diverticulitis (20%) 3) Volvulus (10%) |
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What is a common cause of bowel obstruction in younger patients (i.e. 20s)?
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Inflammatory pseudotumor (inflammatory myofibroblastic tumor)
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What do you do when encountered with SBO in a "virgin" abdomen?
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Pretty much rules out adhesions.
Hernia, mass, midgut volvulus with congenital Ladd bands, patient with cystic fibrosis with inspissated feces. |
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What additional abdominal finding do CF patients get?
mukowiscydoza= CF |
FATTY replacement of pancreas
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What are the bowel obstruction situations most likely to result in strangulation?
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1) Closed loop obstructons
2) Volvulus 3) High grade obstructions (due to increased perfusion pressure) -- high grade obs happens with CA |
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What is sufficient to make dx of closed loop obstruction?
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1) Small bowel obstruction
2) U-shaped loop of distended bowel 3) Clouding of the adjacent mesentery OR See distended loop of bowel with two limbs in close contiguity and obstruction proximal to this region. |
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What is a sign of bowel ischemia that predates absence of enhancement?
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Target sign: See mural stratification or just see thickening and prominent enhancement of the mucosal surface.
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niedokrwienie jelia => zawał - jakie sie objawia
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pogrubiała wzmacniająca się ściana => cienka jak papier bez wzmocnienia; potem pneumatosis
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Post-op patient with dilated ascending colon and SBO with collapsed descending colon. You want to r/o an obstructing lesion. CT is indeterminate. What do you do?
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Put patient on fluoro table, do single contrast BE just to demonstrate normal transverse colon. If normal, you know patient just has a variant pattern of adynamic ileus.
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When is enteroclysis preferred over CT?
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Chronic recurrent obstruction. Enteroclysis is good for challenging the small bowel to look for areas of poor dilation, which may reflect adhesions that can be removed laparoscopically.
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