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Intestinal Obstruction

Hongyi Cui, M.D., Ph.D. Reviewed 06/2022
 


BASICS

DESCRIPTION

  • Blockage of intraluminal contents from normal intestinal transport

  • This blockage can be partial or complete. It can be the result of mechanical or functional causes.

  • Consider intestina...

DIAGNOSIS

HISTORY

  • Abdominal pain:

    • Diffuse

    • Poorly localized cramping generally at intervals of 5 to 15 minutes

  • Abdominal distention:

    • More common with distal obstructions

  • Emesis:

    • Usually occurs immediately aft...

TREATMENT

  • Inpatient management generally recommended

  • Clinically stable patients may be treated conservatively with bowel rest, nasogastric suction, and IV fluid resuscitation. Use opioids with caution.

  • ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • Daily monitoring with series abdominal exams in hospital

  • Postoperative outpatient follow-up in 1 to 2 weeks

DIET

NPO until obstruction resolved, an...

REFERENCES

1
Ha  GW, Lee  MR, Kim  JH. Adhesive small bowel obstruction after laparoscopic and open colorectal surgery: a systemic review and meta-analysis. Am J Surg. ...

ADDITIONAL READING

  • Bower KL, Lollar DI, Williams SL, et al. Small bowel obstruction.  Surg Clin North America. 2018;98(5):945–971.

  • Kostenbauer J, Truskett PG. ...

CODES

ICD10

  • K56.60 Unspecified intestinal obstruction

  • K56.41 Fecal impaction

  • K56.69 Other intestinal obstruction

  • Q41.9 Congen absence, atresia and stenosis of sm int, part unsp

  • K56.49 Other impaction of in...

CLINICAL PEARLS

  • Clinical history and plain films establish the diagnosis in most cases.

  • 15–20% of patients with colorectal cancer present with colonic obstruction.

  • Initial management involves early surg...

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