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16 Cards in this Set
- Front
- Back
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Name four common causes of small bowel obstruction.
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1) Adhesions
Also, hernias, cancer, Crohn's disease. The ABCs of small bowel obstruction: A - adhesions B - bulges (hernias) C - cancer, Crohn's |
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What are the symptoms and signs of small bowel obstruction?
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Symptoms:
1) Colicky abdominal pain 2) Nausea/vomiting 3) Constipation Signs: High frequency bowel sounds Distention |
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What MUST you look for on physical exam for small bowel obstruction?
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Hernias
Digital rectal examination. |
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How can SBO be distinguished from ileus?
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Bowel obstruction displays a transition point between dilated proximal bowel and normal-caliber distal bowel, while ileus is just diffusely distended.
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What are the symptoms of small bowel obstruction?
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1) Crampy, colicky abdominal pain.
2) Nausea and bilious vomiting 3) Constipation |
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What are the signs of small bowel obstruction?
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High-pitched bowel sounds, tenderness, distention.
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Which acid/base, electrolyte, and fluid disturbances are classically associated with proximal obstruction?
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Hypovolemia
Alkalosis Hypokalemia |
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You're doing a physical exam on somebody for possible SBO. What MUST you look for that you could forget.
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HERNIAS (check groin)
Also, as always, do a DRE so as to check for blood. |
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What radiographic studies might you order for someone with suspected SBO?
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The so-called "abdominal series"
-consists of supine AXR, upright AXR, and upright CXR -distended loops of bowel (>3 cm) -air-fluid levels Small-bowel follow-through CT with oral contrast |
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Into what groups can all small bowel obstructions be divided into?
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Partial and complete
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Name some potential complications of small bowel obstruction.
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Strangulation and necrosis
Fluid, electrolyte, and acid-base disturbances ?Perforation? |
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What is the treatment of someone with complete small bowel obstruction?
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Laparotomy with lysis of adhesions
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What is the treatment of someone with partial small bowel obstruction?
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Conservative treatment (resuscitation, monitoring, NGT compression)
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A patient has flatus and bowel movements. Can they have a small bowel obstruction?
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Yes; the bowel distal to the obstruction can clear out gas and stool.
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What are the signs of strangulated bowel?
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Fever
Shock Peritoneal signs Acidosis (from lactic acid) |
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What condition commonly mimics SBO?
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Paralytic ileus
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