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The first step in diagnosis is to determine the etiology of abdominal distension. After making a differential diagnosis of abdominal distension, it is important to take a careful medical history. [9] Here are the most common causes of abdominal distension classified as an underlying cause and as a secondary disease. As an underlying disease cause:
This causes symptoms due to the shift of fluid into the intestinal lumen, with plasma volume contraction and acute intestinal distention. [3] Osmotic diarrhea, distension of the small bowel leading to crampy abdominal pain, and reduced blood volume can result. Late dumping syndrome occurs 2 to 3 hours after a meal.
Depending on the level of obstruction, bowel obstruction can present with abdominal pain, abdominal distension, and constipation.Bowel obstruction may be complicated by dehydration and electrolyte abnormalities due to vomiting; respiratory compromise from pressure on the diaphragm by a distended abdomen, or aspiration of vomitus; bowel ischemia or perforation from prolonged distension or ...
The small bowel feces sign results from stagnation of enteric contents within dilated segments of the small intestine. [1] When intestinal motility is impaired due to obstruction, progressive dehydration of luminal contents occurs, leading to the formation of solid particulate matter that mimics feces. [3]
When the ileocecal valve is competent, colonic obstruction may manifest as gaseous distention of the colon, but not the small intestine; when the ileocecal valve is incompetent, it does not prevent retrograde passage of air and stool and a colonic obstruction will cause dilation of both large and small bowel.
An anatomic lead point (that is, a piece of intestinal tissue that protrudes into the bowel lumen) is present in approximately 10% of intussusceptions. [5] The lead point (best exemplified by a polyp) serves as a focal area of traction, which the peristaltic action pulls into the distal bowel, thus invaginating the attached bowel segment. [6]
An enterocele is a protrusion of peritoneal folds between the rectum and the vagina containing a loop of the small intestine. [19] It is abnormal descent of the small bowel in a deep pouch of Douglas. [20] Enterocoele may develop because of weakening pelvic floor, multiple pregnancies, hysterectomy, and long term chronic straining.
Intestinal decompression by tube placement in a small stoma can also be used to reduce distension and pressure within the gut. The stoma may be a gastrostomy, jejunostomy, ileostomy, or cecostomy. These may be used for feed (e.g. gastrostomy and jejunostomy) or to flush the intestines.