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17 Cards in this Set
- Front
- Back
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what is the most common cause of gastric outlet osbsrutciont
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peptic ulcer: scarring at pylorus
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what are other causes of gastric outlet obsruction?
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gastric cancer
antral web gastroparesis |
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early satiety, wt loss, refulx
solid--> liquid diet non billious vomitting afebrile, dehyderate |
gastric outlet obstruction
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HYPOkalemic
HYPOchloremic metaboilic alkalosis low albumin |
gastric outlet obstruction
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what is the most common SBO in the western world?
whoel world? |
adhesions from surgery
hernias |
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whar is the most common tumor that metastasizes to small bowel?
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melanoma
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what is the most common inflammatory process that can cause SBO?
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crohns diseas
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whats a gallstone ileus?
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mechanical obstruction due to gall stone corroding into duodenuma nd getting stuck at the ileocecal valve
usually occurs in older pts with comorbidities |
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colicky ab pain
distenstion-visceral pain clogged sink analogy vomiting- (billoiu/feculent) absence of stool/flatus |
sbo obstruction
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what is the pathophys of sbo?
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dilation proximal to obstruction
accum gas and fluid edema decrease venous return bacteria adn endotoxin translocation (bc intestines are leaky) infaction |
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borborygmi
empty vault rectum |
SBO!
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what is ileus and what causes it?
seen: no collicky pain, just distension |
si not moving contents forward, but no mechanicol obstruction
from trauma or surgery sepsis inflammation |
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how do you dx sbo?
lab CXR CT |
lab: BUN and creatinine high, changes in Na and or K
see ari fluid levesl ct: defines transtition pt. |
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obstipation
prgressive distension rapid aif volvulus (vomit late finding) |
LBO
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where do you see volvulus?
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mostly sigmoid colon (decompress and elective surgery)
also cecum (ressect) |
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what is the most common location of LBO due to DD?
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sigmoid colon
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elderly pt following hip replacement (any ortho procedure) hasnt had bm for a week
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olgivies syndrom (colonic pseudoobsruction)
paralytic ileus of colon, usuallly associated w/electrolyte imbalanc HYPOkalemia and narcotics tx: stop narcotics, cecum>10cm operate, r/o distal ob neostigmine |
