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16 Cards in this Set
- Front
- Back
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Name 4 most common causes of mechanical obstruction of intestines (80% cases)
What comprises of the other 10-15%? |
Commonest:
Hernias Adhesions Intussusception (telescoping) Volvulus (twisting) Other: Tumours Infarction |
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Name 4 types of hernias.
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Inguinal (indirect, direct)
Femoral Incisional (surgical) Hiatus (of stomach) Diaphargmatic Epigastric Umbilical Richter |
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Which type comprises of 75% of hernias?
Which type comprises of 15-20%? |
75%: Groin (Inguinal + Femoral)
15-20%: Incisional (surgical) |
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MECHANISM: Hernia
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Weakness in wall of peritoneal cavity
= Protrusion of hernia sac |
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Describe hernia sac.
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Serosa-lined pouch of peritoneum.
May/may not have abdominal contents. |
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MECHANISM: Hernial obstruction.
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Herniation of whole small bowel loop
= Total lumenal obstruction |
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MECHANISM: Hernial incarceration
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Hernial obstruction
-> ↑ pressure at neck of pouch -> Venous drainage of hernia impaired -> ↑ bulk of herniated loop (Stasis + oedema) = Permanent entrapment |
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MECHANISM: Hernial strangulation
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Hernial incarceration
= Arterial + venous compromise -> Gangrene of sac contents |
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MECHANISM: Adhesions
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Peritoneal inflammation
(Surgical procedures, infection, endometriosis) = Adhesion between bowel segments, abdominal wall, operative sites |
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MECHANISM: Adhesions (Internal herniation)
Consequences? |
Fibrous bridges of adesions form closed loops
-> Other viscera become entrapped = Internal herniation -> Obstruction + strangulation |
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MECHANISM: Volvulus
Consequences? |
Complete twisting of bowel loop
= Volvulus -> Luminal + vascular compromise (obstruction + infarction) |
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MECHANISMS: Intussusception
Consequences? |
Intestinal segment
-> Constricted by peristaltic wave -> Segment telescopes (invaginates) into immediate distal segment = Intussusception (Lumenal obstruction) -> Segment trapped -> Segment propelled by peristalsis -> Mesentery pulled along for ride -> Compression of mesenteric vessels = Infarction |
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AETIOLOGY: Intussusception
In infants & children. |
Usually no anatomical defect, patients otherwise healthy
Some cases involve rotavirus infection |
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Tx: Intussusception
In infants & children. |
Barium enema
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AETIOLOGY: Intussusception
In older children & adults |
Intraluminal mass/tumor becomes point of traction
-> Intussusception |
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Tx: Intussusception
In older children & adults |
Surgery
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