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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 ...
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.
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 ]
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:
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.
Clinically, patients present with diffuse abdominal pain, bowel distention, and bloody diarrhea. On physical exam, bowel sounds will be absent. Laboratory tests reveal a neutrophilic leukocytosis, sometimes with a left shift, and increased serum amylase. Abdominal radiography will show many air-fluid levels, as well as widespread edema.
Intestinal ischemia is a medical condition in which injury to the large or small intestine occurs due to not enough blood supply. [2] It can come on suddenly, known as acute intestinal ischemia, or gradually, known as chronic intestinal ischemia. [ 1 ]
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.