Tongue with intestinal obstruction. Intestinal obstruction and its treatment. Preoperative preparation for the treatment of intestinal obstruction

Human health and well-being largely depend on the proper functioning of the gastrointestinal tract and the timely removal of waste products from the body. Failure in the normal functioning of the intestines leads to illness, and more serious disorders can cause life-threatening conditions. One of these serious complications is intestinal obstruction.

Intestinal obstruction is a syndrome caused by impaired intestinal motility or mechanical obstruction and leading to the inability to move its contents along the digestive tract.

Intestinal obstruction can be caused by a variety of provoking factors. The generally accepted classification of intestinal obstruction largely helps to understand the cause of the disease.

All forms of intestinal obstruction are divided into the following types:

By origin:

  • Congenital
  • Purchased

Congenital obstruction is diagnosed with congenital pathologies such as the absence of the large, small intestine or anus. All other cases of obstruction are classified as acquired.

According to the mechanism of occurrence, intestinal obstruction occurs

  • Mechanical
  • Dynamic

According to the clinical course

  • Full
  • partial
  • Acute
  • Chronic

According to the options for compressing the vessels supplying the intestine:

  • Strangulation (with compression of mesenteric vessels)
  • Obstructive (when a mechanical obstacle occurs)
  • Combined (in which both syndromes are expressed)

Causes of intestinal obstruction

Let's take a closer look at what factors cause this or that type of intestinal obstruction. The causes of mechanical intestinal obstruction include:

  • Disorders of the structure of internal organs, mobile cecum
  • Congenital cords of peritoneum, abnormally long sigmoid colon
  • Adhesions developing after surgery
  • Strangulated hernia
  • Incorrect formation of the intestines (twisting of intestinal loops, formation of nodes)
  • Closure of the intestinal lumen by cancerous neoplasms and tumors emanating from other abdominal organs
  • Blockage of the intestines by foreign bodies (accidentally swallowed objects, gallstones or fecal stones, accumulation of helminths).
  • Volvulus of one of the intestinal sections
  • Meconium accumulation
  • Narrowing of the intestinal lumen due to vascular diseases, endometriosis
  • Invagination of the intestinal walls, which occurs when one section of it is pulled into another and blocks the lumen

Dynamic intestinal obstruction, in turn, is divided into spastic and paralytic. The spastic form is extremely rare and largely precedes the paralytic state of the intestine. The causes of paralytic ileus are:

  • Traumatic operations on the abdominal organs
  • Peritonitis and inflammatory diseases of internal organs
  • Closed and open abdominal injuries

Sometimes an additional provoking factor causing changes in motility and the development of intestinal obstruction can be a change in diet. Such cases include consuming large amounts of high-calorie food during a long period of fasting, which can provoke intestinal volvulus. A complication can be caused by a sharp increase in the consumption of vegetables and fruits during the season, or the transfer of a child in the first year of life from breastfeeding to artificial feeding.

The main symptoms of intestinal obstruction include:

In addition to these main signs, there are a number of other specific symptoms that only a specialist can understand. During the examination, the doctor may pay attention to characteristic gurgling sounds in the abdominal cavity or their complete absence, which may indicate a complete shutdown of intestinal motility.

If the disease progresses and medical care is not provided, the pain may subside within 2-3 days. This is a bad prognostic sign, as it indicates a complete cessation of intestinal motility. Another ominous sign is vomiting, which can become severe. It can become repeated and indomitable.

First, the contents of the stomach begin to leave, then the vomit mixes with bile and gradually turns greenish-brown. Abdominal tension may be severe and the abdomen may be distended like a drum. As a later symptom, after about a day, absence of stool syndrome and the inability to pass feces may develop.

In the absence of treatment or late seeking medical help, a drop in blood pressure, increased heart rate, and the development of shock are observed. This condition provokes a large loss of fluid and electrolytes with repeated vomiting, intoxication of the body with stagnant intestinal contents. A life-threatening condition develops that requires emergency medical attention.

Diagnostics

If threatening symptoms appear, you must urgently seek medical help and undergo an examination to clarify the diagnosis. After the examination, the patient is prescribed laboratory tests of blood and urine, in addition, it will be necessary to undergo fluoroscopy and ultrasound.

  1. An X-ray examination of the abdominal organs reveals specific symptoms of intestinal obstruction. The images will show swollen intestinal loops, overflowing with contents and gas (the so-called intestinal arches and Kloiber's cups).
  2. An ultrasound examination confirms the diagnosis by the presence of free fluid in the abdominal cavity and distended intestinal loops.

If the diagnosis is confirmed, the patient should be urgently hospitalized in the surgical department. In a hospital setting, it is possible to conduct repeated examinations using irrigoscopy and colonoscopy.

  • Emergency irrigoscopy is performed to identify pathologies in the colon. In this case, the intestine is filled with a barium suspension using an enema and X-ray photographs are taken. This will allow you to assess the dynamics of the disease and determine the level of obstruction.
  • The colon is cleaned with an enema and a flexible endoscope is inserted through the anus to visually inspect the colon. This method allows you to detect a tumor, take a piece of tissue for a biopsy, or intubate a narrowed section of the intestine, thereby eliminating the manifestations of acute intestinal obstruction.

It is important to conduct a vaginal or rectal examination. Thus, it is possible to identify pelvic tumors and obstruction (blockage) of the rectum.

In difficult cases, laparoscopy can be performed in a hospital setting, when an endoscope is inserted through a puncture in the anterior abdominal wall and the condition of the internal organs is visually assessed.

Possible complications

In the absence of medical attention, intestinal obstruction can cause dangerous, life-threatening complications for the patient.

  • Necrosis (death) of the affected area of ​​the intestine. An intestinal obstruction can cause blood flow to a certain area of ​​the intestine to be cut off, causing tissue death and can cause the intestinal wall to perforate and leak contents into the abdominal cavity.
  • Peritonitis. It develops when the intestinal wall is perforated and an infectious process joins. Inflammation of the peritoneum leads to blood poisoning (sepsis). This condition is life-threatening and requires immediate surgical intervention.

Intestinal obstruction in children can be congenital or acquired. In newborns, intestinal obstruction is most often congenital and occurs due to intestinal malformations. This may be an abnormal narrowing of the intestine, strangulation of intestinal loops, an elongated sigmoid colon, disturbances of rotation and fixation of the mid-intestine, anomalies leading to closure of the intestinal walls.

The cause of acute obstruction in newborns may be intestinal blockage with meconium (high-viscosity feces). In this case, the baby has a lack of stool, a large accumulation of gases, due to which the upper part of the tummy swells and vomiting begins with an admixture of bile.

In infants, a specific type of intestinal obstruction such as intussusception is often observed, when part of the small intestine is inserted into the large intestine. Intussusception is manifested by frequent painful attacks, vomiting, and instead of feces, mucus and blood are released from the anus. The development of the anomaly is facilitated by the mobility of the colon and the immaturity of the peristalsis mechanism. This condition is observed mainly in boys aged 5 to 10 months.

Intestinal obstruction in children is often caused by an accumulation of worms. A ball of roundworms or other helminths clogs the intestinal lumen and causes spasm. Intestinal spasm can be very persistent and cause partial or complete obstruction. In addition, sudden changes in diet or earlier initiation of complementary feeding can lead to peristalsis disturbances in children.

In children under one year of age, adhesive intestinal obstruction may be diagnosed, which occurs after operations or due to the immaturity of the digestive system due to birth injuries or intestinal infections. An adhesive process in the abdominal cavity can cause volvulus. Children are very mobile; when running or jumping, a loop of intestine can wrap around the cords of the commissure.

Acute adhesive obstruction at an early age is a very dangerous complication, resulting in a high mortality rate. Operations to remove the affected part of the intestine are technically complex; in children it is very difficult to sew together the thin intestinal walls, since there is a high risk of intestinal perforation.

Symptoms of acute obstruction in children manifest themselves in sharp cramping pain, bloating, and painful vomiting. Indomitable vomiting is more often observed with volvulus of the small intestine. First, food remains are present in the vomit, then bile mixed with meconium begins to come out.

If the colon is affected, vomiting may be absent, gas retention, bloating and abdominal tension are noted. The cramping pain is so severe that the child cannot cry. When the attacks of pain pass, the child becomes very restless, cries and finds no rest.

Any type of intestinal obstruction in children requires immediate hospitalization. Congenital intestinal obstruction in newborns is treated surgically. Urgent surgical intervention is necessary in case of intestinal volvulus and other emergency situations. Conservative treatment is carried out in cases where the cause of obstruction is functional impairment.

Once the diagnosis is confirmed, the patient is hospitalized in a surgical hospital. The patient must be examined by a doctor; before the examination, it is forbidden to give the patient painkillers or laxatives, perform an enema or gastric lavage. Emergency surgery is performed only for peritonitis.

In other cases, treatment begins with conservative therapy methods. Therapeutic measures should be aimed at relieving pain, combating intoxication of the body, restoring water-salt metabolism, and removing stagnant intestinal contents.

The patient is prescribed hunger and rest and emergency treatment is started. therapeutic measures:

  • Using a flexible probe inserted into the stomach through the nose, the upper parts of the digestive tract are cleared of stagnant contents. This helps stop vomiting.
  • Intravenous administration of solutions is started to restore the water-salt balance of the body.
  • Painkillers and antiemetics are prescribed.
  • For severe peristalsis, antispasmodic drugs (atropine, no-shpu) are used.
  • To stimulate intestinal motility in cases of severe paresis, proserin is administered subcutaneously

Treatment of functional (paralytic) intestinal obstruction is carried out with the help of medications, which stimulate muscle contraction and promote the movement of contents along the digestive tract. Such obstruction is most often a temporary condition and within a few days, with proper treatment, its symptoms may disappear.

If conservative therapy is ineffective, surgical intervention is performed. In case of intestinal obstruction, operations are aimed at eliminating mechanical blockage, removing the affected part of the intestine and preventing a recurrence of obstruction.

In the postoperative period, measures continue to be taken for intravenous administration of blood substitutes and saline solutions to restore electrolyte balance. Carry out anticoagulant and anti-inflammatory therapy, stimulate motor-evacuation functions of the intestine.

In the first few days after surgery, the patient must remain in bed. You can drink and eat only after the permission and recommendations of your doctor. You should not eat or drink anything for the first 12 hours. At this time, the patient is fed intravenously or using a tube through which liquid nutritional mixtures are supplied. To reduce the load on postoperative sutures, you can only get up and walk after the intervention with a special orthopedic bandage.

Prognosis and prevention of obstruction

A favorable prognosis for the treatment of intestinal obstruction depends on the timeliness of medical care. You cannot delay seeing a doctor, otherwise if severe complications develop, there is a high risk of death. An unfavorable outcome may occur with late diagnosis, in weakened and elderly patients, in the presence of inoperable malignant tumors. If adhesions occur in the abdominal cavity, relapses of intestinal obstruction are possible.

Preventive measures to prevent intestinal obstruction include timely detection and removal of intestinal tumors, treatment of helminthic infestations, prevention of adhesions and abdominal injuries, and proper nutrition.

Treatment of intestinal obstruction with folk remedies

In case of intestinal obstruction, self-medication is extremely dangerous, as it can be fatal. Therefore, traditional medicine recipes can only be used after consultation with a doctor and under his direct supervision.

Traditional methods are used to treat only partial intestinal obstruction, if the disease is chronic and does not require surgical intervention. The patient must choose the optimal treatment method together with the doctor. This approach will avoid exacerbation of the disease and the development of dangerous complications.

Juice from sea buckthorn berries has a pronounced anti-inflammatory effect, and sea buckthorn oil acts as a mild laxative. To prepare the juice, a kilogram of berries is washed, placed in a container and crushed. The crushed berries are mixed and the juice is squeezed out of them. Take 100 g of juice once a day half an hour before meals.

To prepare the oil, 1 kg of sea buckthorn fruit is ground with a wooden spoon and left in an enamel container for a day. After this period, up to 90 g of oil accumulates on the surface of the pureed mass. It is collected and drunk 1 teaspoon three times a day before meals.

  • Treatment with dried fruits. To prepare the remedy, take 10 tablespoons of dried plums, dried apricots, figs and raisins. The dried fruit mixture is washed well and poured with boiling water overnight. In the morning, everything is passed through a meat grinder, 50 g of honey is added and mixed well. Take one tablespoon of the prepared mixture daily before breakfast.
  • Treatment with plum decoction. This decoction acts as a mild laxative. To prepare it, 500 g of pitted plums are washed, filled with cold water and simmered over low heat for about an hour. The finished broth is topped up with water to the previous level and allowed to boil again. Drink chilled, 1/2 glass three times a day.

The main recommendations for intestinal obstruction are to limit the amount of food consumed. In no case should overeating be allowed; this can lead to an exacerbation of symptoms in chronic obstruction. Meals should be fractional, you need to eat every 2 hours, in very small portions. The calorie content of the diet is only 1020 Kcal. Every day the diet should contain carbohydrates (200 g), proteins (80 g), fats (50 g). The maximum volume of liquid should not exceed 2 liters per day.

Products that cause gas formation, whole milk and dairy products, dense dishes, and carbonated drinks are completely excluded. The purpose of such a diet is to eliminate fermentation and putrefactive processes in the gastrointestinal tract. All irritants of mechanical, thermal or chemical types are excluded. Food should be as gentle as possible, pureed or jelly-like, at a comfortable temperature (neither hot nor cold).

The basis of the diet should be weak, low-fat meat broths, mucous decoctions, and pureed or pureed dishes. You can cook pureed porridge in water, cottage cheese and egg soufflés, and light omelettes. It is better to eat meat in the form of steamed cutlets, meatballs, and quenelles. Jelly, fruit jellies, and fermented milk drinks are useful. For drinks, green tea, rosehip, blueberry or quince infusions are preferable.

Excluded from the diet are flour and confectionery products, fried and hard-boiled eggs, fatty meats and fish, pickles, smoked foods, canned meat and fish, and caviar. Raw vegetables, pasta, pearl barley, millet or barley porridge are not recommended. The use of butter is limited; no more than 5 g of butter can be added to dishes per day.

You cannot drink carbonated and cold drinks, cocoa, coffee and tea with milk. Salty and spicy dishes, seasonings, rich fish, meat and mushroom broths are excluded from the menu. You should not eat legumes, greens and vegetables containing coarse fiber (cabbage, radishes, radishes, turnips). All other vegetables must not be eaten raw; they must be boiled, stewed or baked.

In case of intestinal obstruction, the main goal of the diet is to unload the intestines, exclude indigestible food and limit its volume. Such a diet will improve the patient’s condition and help avoid exacerbation of the disease.

Problems related to bowel function are common among modern populations. One of the most dangerous pathologies affecting the intestines is its obstruction. If manifestations of this disease are detected, emergency assistance from surgeons is required. Without treatment, various complications are possible, including death. The first symptom of obstruction is cramping, increasing pain. In rare cases, pain increases gradually.

Etiology of the pathological condition

Intestinal obstruction is a kind of blockage of the intestine when the contents cannot move towards the anus. This provokes difficulty in the process of emptying the intestines and the passage of gases, as a result of which gases are formed. The clinical picture becomes clearer when the patient's condition worsens sharply. The main source of such ailment is irregular bowel movements. Within normal limits, a person should defecate at least once a day. If the patient suffers from constipation or there are signs of obstruction, you should visit a doctor without delay.

Intestinal obstruction develops due to exposure to various factors. The reasons for its occurrence are mechanical and functional. Causes of a mechanical nature include adhesions, a mobile cecum, pockets in the peritoneum, and elongation of the sigmoid colon. Functional intestinal obstruction occurs against the background of overeating after a diet, a sudden increase in fresh vegetables and fruits in the diet, as well as the transfer of an infant to formula before the age of one year.

Complete or partial mechanical intestinal obstruction occurs for the following reasons:

  • helminthic infestations;
  • inflammatory processes;
  • presence of hematoma;
  • oncology;
  • hernia and adhesions;
  • changes in the structure of the abdominal cavity;
  • improper formation of the intestines;
  • fecal, gallstones;
  • intestinal obstruction;
  • cases of intussusception;
  • reduction in the size of the intestinal lumen;
  • volvulus of some parts of the intestine;
  • congenital cords of the abdominal cavity.

The following factors can provoke functional obstruction: intestinal motility disorders, Hirschsprung's disease, spasms and paralytic processes.

Clinical picture of obstruction


If intestinal obstruction is suspected, the patient should be urgently taken to surgery. Timely assistance is the key to a positive prognosis. In some cases, it is possible to eliminate the problem without surgical intervention. The main symptom indicating obstruction is the problematic passage of gases and feces. With partial obstruction or damage to the upper part of the organ, there is a slight discharge of gases and scanty stool. Basically, vomiting, nausea, severe cramping pain in the abdomen, bloating and asymmetry of the abdomen are manifested.

In addition to the listed symptoms, there are specific signs that only a doctor can identify. Therefore, urgent hospitalization is a necessary measure. In case of complications, the risk of death, development of kidney and liver failure, as well as disturbances in the functioning of the heart muscle increases.

You need to be especially careful if you suspect obstruction in infants. If at least one manifestation of the disease is detected, you must urgently seek medical help. Symptoms accompanying intestinal obstruction:

  • gray skin color;
  • bloating in the baby's upper abdomen;
  • weight loss;
  • bilious vomiting, especially after feeding;
  • elevated body temperature.

The child becomes whiny, capricious and restless, and refuses food. In this case, call an ambulance immediately.

Classification of intestinal obstruction

Pathology can be complete or partial, and occurs in acute or chronic form.

As for the origin, the disease can be congenital or acquired. The cause of the congenital form is considered to be blockage of the intestine with dense meconium, as well as abnormal development of the organ. Considering the causes of the ailment, the character can be dynamic and mechanical.

With partial intestinal obstruction, the symptoms are chronic. The patient vomits from time to time, there is retention of stool and gas, and periodic pain. Basically, the clinical picture is not acute. In some cases, symptoms subside on their own. The disease can last for several decades. If the cause of the pathology is a tumor growing inside, the symptoms appear and intensify gradually. Flatulence, constipation, pain and vomiting occur.

As for the stages of partial blockage, they are replaced by periods of resolution, which occur against the background of diarrhea. During this period, feces become abundant and liquid, and have a putrid odor. The main feature of the partial form of pathology is that over time it can become complete and acute.

Another form of pathology is adhesive obstruction. This type of obstruction is characterized by impaired passage through the organ caused by adhesions in the abdominal cavity. Adhesions and cords are the result of acute, limited peritonitis, trauma to the abdominal area, and hemorrhage. This type of obstruction can affect any part of the intestine. Most often, adhesions occur in the omentum with a postoperative scar. The basis of the pathology is incorrect and impaired peristalsis of this organ, caused by the formation of adhesions. There are several types:

  • Obstructive – the onset and course of the disease is acute, sudden. In some cases, chronic obstruction develops into an acute stage.
  • Strangulation - manifests itself against the background of strangulation of part of the intestine, the mesentery is involved in the process. The course of the pathology is rapid and acute. Hemodynamic disorders appear, provoking the development of peritonitis and.
  • Mixed - pathology combines the features of mechanical and dynamic obstruction.

The next type is small intestinal obstruction. Pathology can affect any part of a given intestine. In this case, the part of the intestine that is located above the site of the lesion does not stop working, so it begins to swell. As for the cause of the malaise, most often it is intestinal obstruction. The main signs of obstruction are: vomiting, severe pain in the epigastric region, aversion to food, flatulence, and dehydration.

Pathology of the large intestine occurs against the background of impaired passage through the intestine, accompanied by bloating, cramping pain, difficult passage of gases, lack of stool, vomiting and flatulence. The disease can be partial or complete. In most cases, the damage is organic. If the pathology progresses, the signs of intoxication noticeably increase, metabolism is disrupted, and diarrhea gives way to constipation.

Medical therapy


First of all, it is necessary to perform a diagnosis to confirm the diagnosis. Urgent measures are taken to help relieve pain shock and quickly replenish lost fluid. X-ray and ultrasound examination are required. Using a probe, the upper part of the organ is released, and using a siphon enema, the lower part is released. Antispasmodics must be administered to relax the intestinal muscles and stop increased peristalsis. In some cases, these measures are enough to restore the functioning of the gastrointestinal tract. If this treatment approach does not help, emergency surgery is required.

Surgery is mandatory in the following situations:

  • intussusception;
  • volvulus of the small intestine;
  • blockage from gallstones;
  • wrapping one gut around another.

Depending on how the pathology proceeds, the patient is prescribed appropriate diet therapy. After the operation, it is forbidden to drink or eat for twelve hours. Nutrition is carried out parenterally: nutrient solutions are administered intravenously. After some time, baby food and fermented milk products are added to the diet. Then the patient is transferred to dietary table No. 4, which should be followed for at least 3 months.

Intestinal obstruction is a dangerous disease that requires emergency medical attention. If you notice any suspicious symptoms, call an ambulance.

Intestinal obstruction is a fairly common problem faced by a large number of patients. Various therapeutic methods are now offered that can quickly overcome the disease. In this case, it is necessary to establish the cause of the disease.

General information about the disease

Intestinal obstruction occurs quite often in the practice of medical staff. There are mechanical and dynamic varieties. These two forms have signs characteristic of intestinal volvulus. These are types of intestinal obstruction. The disease can occur in an acute form or develop slowly in a chronic form.

For what reasons can mechanical intestinal obstruction occur? In this case, experts identify the following reasons:

  • strangulated hernia;
  • worms (because of them the passage in the intestines becomes clogged);
  • volvulus;
  • intussusception (the process involves the introduction of an intestine into another);
  • presence of a foreign body in the intestine;
  • formation of adhesions and nodes;
  • clogging processes caused by the accumulation of feces or food masses.

About dynamic obstruction

Dynamic obstruction of the colon is caused by disorders associated with intestinal motility. In addition, various pathologies and diseases of organs located in the abdominal region can lead to negative consequences. Problems can arise in other internal organs, the functioning of which directly affects the functioning of the intestines. At the same time, disruptions in the functioning of the nervous system occur, and they precede this disease.

Among the reasons that cause dynamic intestinal obstruction, it is worth highlighting: pathological changes affecting electrolyte balance and acid-base imbalance. In some cases, obstruction of the small intestine may be the result of complications arising after operations on the organ. The disease is also observed when patients develop adhesions or inflammatory diseases affecting the gastrointestinal tract.

Intestinal blockage can occur due to poor diet. Thus, cases are considered when the patient eats meat very often and in large quantities. In addition, fatty foods can be consumed in significant quantities, against the background of which there is no consumption of fresh fruits and vegetables. Therefore, you need to monitor your menu very carefully.

Constipation and obstruction can occur due to increased peristalsis and increased intrauterine pressure. All these negative phenomena lead to the fact that the intestine is compressed or infringed. Constipation occurs due to inversion of the organ due to the large length or narrowness of the root of the mesentery. Obstruction syndrome can begin due to intestinal volvulus, which occurs due to impaired intestinal motility.

Obstructive obstruction is activated for the following reasons:

  • tumor (including benign);
  • fecal debris;
  • gallstone;
  • balls of roundworms;
  • inflammatory processes;
  • intestinal tuberculosis.

Constipation and obstruction in children are quite rare. If we talk about congenital pathology, then this phenomenon is diagnosed in 20% of cases. The acquired disease often occurs due to the fact that children tend to swallow various objects. As a result, intussusception may occur. Doctors note that you should not resort to self-medication, as this can only worsen the situation.

Clinical picture

Acute intestinal obstruction has specific symptoms, which make it possible to diagnose the disease in a fairly short time period. Painful sensations accompany the pathology in almost all cases, and the pain occurs suddenly. It can be cramping, and its intensity can be unexpressed.

A sign of intestinal obstruction is vomiting and nausea. In addition, the following symptoms may be present:

  • bloating in the abdomen;
  • gases;
  • constipation.

Low patency may worsen and the disease begins to progress. This leads to vomiting becoming more pronounced and nausea increasing. In some cases, an unpleasant odor may appear in the patient's mouth. Gases do not escape, but accumulate in the abdominal cavity.

Also, almost all patients with the diagnosis in question are not able to inhale large amounts of air. All of these symptoms indicate that it is urgently necessary to resort to measures aimed at treating intestinal obstruction. Depending on what symptoms are inherent in a particular case, obstruction syndrome can proceed as follows: sudden appearance and gradual decrease, gradual increase and decrease during periods of remission.

There is a whole classification of intestinal obstruction, but in almost all cases there are a number of characteristic symptomatic signs. First of all, it is pain. At the first stage of the development of the disease, colic is felt throughout the intestines, and it is almost impossible to determine the exact localization of the syndrome.

After the pain increases to a certain period, it becomes constant, subsequently it can cover almost the entire abdominal cavity. As a result, some patients may develop peritonitis, in which case only surgery can solve the problem. If obstruction occurs, the pain effect is constant and does not lose its severity.

Mechanical intestinal obstruction and its other types are accompanied by the presence of vomiting. This symptom usually occurs after abdominal pain appears. This is due to the fact that food cannot pass through the gastrointestinal tract, so stagnation occurs. Low patency can develop into complete obstruction.

The syndrome can be characterized by a blockage that appears in the small intestine (in its upper part), followed by profuse vomiting. There are cases when obstruction is diagnosed in the lower intestine, then vomiting may occur later and be less intense.

More about symptoms

Spastic and other types of illness are almost always accompanied by bloating in the abdominal area. This symptom occurs due to the formation of stagnation of gases and liquids, and in large volumes. All this leads to obstruction of these masses in the anus. Here, not only a physiological, but also a psychological effect is triggered.

Bloating can affect the upper and middle parts of the intestine, but then the process only increases. There are practically no discharges; partial vomiting may occur, but these processes are minimal and are unable to radically change the patient’s condition. Although there is a whole classification of types of obstruction, in almost all cases it affects the large intestine. This leads to extremely unpleasant consequences: the walls of the organ are stretched and the abdomen increases in volume, as it undergoes swelling processes.

If the abdomen becomes swollen, then upon palpation a dull sound occurs, which is called a cylindrical sound. It is formed as a result of a finger hitting the surface of the abdomen. There are cases when patients' organ loops stretch so much that they become visible through the skin.

Paralytic ileus, like some other types, can be characterized by obstruction of gases and feces through the anus. Experts note that these symptomatic manifestations are not the main ones in all cases, so this sign is not always relied upon when making an accurate diagnosis. If a blockage has formed, then mass retention occurs early in the lower part of the large intestine. In cases where the passage is closed in the upper part of the colon, the release of gases can occur within several hours. In most cases, the attending physician insists that if gas patency is present, then the onset of intestinal obstruction is excluded.

All of the above symptoms can be characterized by the following additional signs:

  • loss of appetite;
  • general weakness;
  • increased thirst.

Intestinal paralysis can lead to high levels of dehydration. As a result, heart failure can occur. In addition, the following negative consequences are possible:

  • acute renal failure;
  • urinary retention in the body;
  • blood pressure decreases;
  • heart rate increases.

In some cases, the patient has a fever, but its appearance is usually observed at later stages of the development of the disease. All this happens due to the fact that bacteria enter the general lumen of the intestine, and then into the blood.

What measures should be taken?

What to do if a person has an attack of obstruction? In some cases, a patient without medical help may suspect that there is such a problem in his body. If there is a possibility that intestinal obstruction has occurred, diagnosis should only be carried out by the attending physician, so you must immediately contact an ambulance. Most often, only surgery can overcome the problem in question. Self-medication is unacceptable, as this will only lead to additional complications and health problems.

The classification of intestinal obstruction distinguishes the mechanical type. It is this case that can be eliminated by getting rid of the cause of the condition. To do this, specialists resort to a surgical solution. If we consider a paralytic disease, then all measures must be aimed at eliminating its root cause.

Conservative treatment may include the following measures:

  • use of antibiotics;
  • analgesics;
  • oxygen;
  • other painkillers.

All of them are administered intravenously. However, these measures may be ineffective. It is very important that the operation be performed. It will restore all intestinal functions in the human body. In some cases, there is a need to remove residues that are contained in the organ.

A very common mistake is made when resorting to laxatives. Experts emphasize that this measure is contraindicated, since it only worsens the patient’s condition. Before seeing a doctor, you should not eat or drink anything.

Therapeutic measures

How is the problem treated? Depending on what type of illness is diagnosed in the patient, 2 options can be considered: surgical or conservative treatment. If the patient arrives at a medical facility in a timely manner and in the absence of symptoms of peritonitis or severe volumetric abnormalities, the therapeutic effect on the body should initially be carried out using conservative methods.

The effectiveness of such manipulations is determined based on the available clinical and radiological information. If the patient continues to have pain, this indicates that there is no positive effect. The effect is indicated by the disappearance of intestinal fluid levels. Provided that clinical or radiological signs of the disease are observed, it becomes necessary to perform surgical intervention.

Therapeutic measures for intestinal obstruction are aimed at removing the root cause. The goal is to eliminate intoxication phenomena and restore intestinal motility. To obtain the noted improvements, the patient is indicated for decompression of the stomach and intestines. As part of complex treatment, infusion measures are carried out, thanks to which it is possible to correct pronounced metabolic abnormalities.

Often, during a thorough examination, patients are diagnosed with spastic obstruction. If the doctor is faced with such a diagnosis, not only the main cause of the deviation is eliminated, but palliative actions are also prescribed. To obtain a quick positive result, the patient is recommended to take warm baths.

Recovery occurs faster by taking antispasmodics. Patients are prescribed injections. The most popular drugs are Papaverine, Drotaverine, Platiphylline, etc. Therapy is carried out strictly under the supervision of a doctor without violating the dosage and duration of treatment.

If paralytic obstruction is observed, electrical stimulation of the intestine is prescribed. Cleansing enemas are performed, injections of Ubretide, Proserin or similar drugs are administered. Any mechanical obstruction requires emergency laparotomy. Other approaches are possible if there is adhesive obstruction.

At the first signs of such a disease, you should not self-medicate; you should not test the effects of traditional methods on yourself. This can only make the situation worse. You must immediately contact a specialized medical institution.

AND . The high probability of an extremely severe course with often inevitable death makes it so dangerous that every doctor should be able to recognize it. And not only him.

Causes and types of acute intestinal obstruction

The term “intestinal obstruction” refers to a delay or complete absence of passage of contents through the digestive tube due to a number of reasons. It is on this basis that the disease is mainly divided into types:

A) Mechanical, in which there is a physical obstacle to the passage of the food bolus. In turn, it is divided into:

  1. Obstructive CI resulting from intestinal blockage:
    • fecal stones;
    • bezoars (a lump of hair that accumulates in the stomach mainly in women who love to gnaw on their own curls);
    • large gallstones;
    • foreign bodies;
    • tumors compressing the intestines from the outside, cysts of other localizations.
  2. Strangulation, in which obstruction is caused by:
    • twisting of the intestinal loop around itself;
    • the formation of a knot of several loops;
    • strangulation of the intestine, its mesentery and vessels in the hernial orifice;
    • adhesions or scar cords compressing the intestine from the outside.
  3. Mixed, combining both mechanisms - intussusception, or the introduction of one part of the intestine into another.

B) D dynamic, in which the contents of the intestines do not pass through it due to:

  1. Constant spasm of smooth muscles;
  2. Her permanent paralysis.

Consequences of intestinal obstruction

This disease, if left untreated, leads to a host of serious complications. Thus, turning off part of the intestine, which becomes dead due to a disruption in its blood supply, provokes a disruption in its digestion and absorption of nutrients.

A decrease in the protective functions of the mucous membrane leads to an increase in the permeability of the intestinal wall for bacteria and their metabolic products - severe intoxication occurs, and subsequently bacterial complications: peritonitis, multiple organ failure.

The cessation of absorption in the dead intestine also applies to water. Insufficient intake into the blood, coupled with frequent vomiting, leads to rapid dehydration of the body.

All these phenomena develop relatively quickly and lead to inevitable death within a few days if the patient is not promptly transported to a surgical hospital.

Symptoms of intestinal obstruction

There are three periods in the development of CI, each of which has its own symptoms.

Early period (up to 12 hours)

The disease debuts with pain, the nature and intensity of which differs depending on the type of obstruction. During obstruction, the pain comes in the form of an attack, lasts several minutes, after which it subsides completely. During strangulation, they are constant, but change their intensity from moderate to unbearable, sometimes provoking painful shock.

Vomiting during this period occurs rarely and only if there is an obstruction at the very beginning of the small intestine.

Intermediate period (12 to 24 hours)

12 hours after the onset of pain, the clinical picture becomes as clear as possible. The pain ceases to be paroxysmal with any type of CI, the abdomen swells, and frequent profuse vomiting is noted. Because of this, as well as the inability to take liquids by mouth, swelling of the intestines and the cessation of water absorption, dehydration rapidly increases.

Late period (>24 hours)

During this period, the phenomena of the body’s systemic response to the existing disease increase:

  • breathing rate increases;
  • body temperature rises, which indicates an increase in poisoning of the body with bacterial toxins;
  • urine production stops;
  • severe disturbances of acid-base balance occur;
  • signs of damage to the peritoneum appear - peritonitis;
  • the development of sepsis is possible.

Stopping stool and passing gas is a common, although not constant, symptom of CI. It is more pronounced with low obstruction (obstruction in the colon) and much less pronounced with upper obstruction. However, even in the latter case, at the onset of peritonitis, paralysis of the motor functions of the intestines is noted, leading to a stop in the passage of feces through it.

The patient's condition progressively worsens from moderate to critical, increasing tachycardia is noted, the temperature gradually rises to high numbers (sometimes to extremely high - in the case of sepsis).

If left untreated, the disease inevitably leads to the development of multiple organ failure and death of the patient.

Diagnosis of intestinal obstruction

Objective data alone about the history of the disease and its symptoms are often not enough to make an accurate diagnosis. This is where equipment and laboratory tests come to the aid of doctors:


  • or colonoscopy can clarify the diagnosis of large intestinal obstruction.
  • Ultrasound in some cases provides valuable information about the presence, for example, of a tumor that caused obstruction.
  • Laparoscopy is considered a very informative diagnostic method, during which you can directly see the site of obstruction and even carry out some therapeutic manipulations - cut adhesions, unravel a loop of intestine when it is twisted.

Treatment of intestinal obstruction and first aid

In quite rare cases, with uncomplicated obstructive obstruction, doctors may resort to conservative treatment. This approach is used at the earliest stages, when the process of destruction of the intestinal wall has not yet caused systemic effects. As part of conservative treatment, the following is used:

  • constant pumping of the contents of the stomach and intestines through a tube;
  • siphon enemas;
  • colonoscopy, which sometimes allows you to eliminate intestinal volvulus or “break through” an obstacle, for example, by removing a stone;
  • antispasmodics that relieve intestinal spasms.

In the vast majority of cases, it is still necessary to resort to surgical treatment of intestinal obstruction. This is due to the fact that the start of treatment is often delayed due to late presentation or delayed transportation of the patient and delayed diagnosis of the disease. The “golden 6 hours,” during which there is a chance to eliminate the obstruction without surgery, are missed and the patient ends up on the surgeon’s table.

There are many types of operations that allow you to restore the passage of a food bolus through the intestines. In some cases, part of the dead intestine is removed and the edges of the incisions are sutured; in others, the operation is carried out in two stages:

  • removal of the stoma (the upper end of the intestine is brought out onto the anterior abdominal wall);
  • suturing the ends of the intestine after a few months.

In case of a strangulated hernia, plastic surgery of the hernial orifice and reduction of the intestinal loop, if it is viable, or removal of it in case of necrosis, is performed. When intestinal volvulus occurs, the knot is straightened and the viability of the intestine is assessed. In case of obstructive obstruction, it may be necessary to open the intestine and remove fecal stones, bezoars, etc. from it.

Before the operation, the patient is prepared for a short time by intravenous infusion of solutions, the same thing happens in the intensive care unit after surgery. At the same time, anti-inflammatory drugs, drugs that stimulate intestinal motility, and for peritonitis - antibiotics are used.

A person’s chance of survival with intestinal obstruction directly depends on the speed of providing him with medical care. People operated on in the first 6 hours after the onset of the disease almost all recover, while during an operation performed a day later, every fourth person dies. Depressing statistics allow us to say one thing with confidence - don’t waste time! If there is a long absence of gas and stool, increasing pain and bloating, immediately call an ambulance. Time is the only currency with which you can buy life with intestinal obstruction.

Partial intestinal obstruction is often a chronic pathological process, which is characterized by a violation of the movement of substances through this organ. The disease often affects people of working age, but is often diagnosed in newborns and young children. The main factors in the occurrence of the disease are the presence of various neoplasms in the intestine, complications after surgery, and also if the person has a history of adhesive disease.

The clinical picture of this disorder is periodic. The main symptoms may include abnormal stool and gas formation, pain, attacks of nausea and vomiting. There is an asymptomatic course of the disease. In such cases, complications are discovered during diagnosis, including peritonitis.

When diagnosing this type of intestinal obstruction, data from the medical history and physical examination must be taken into account. In this case, it is necessary to perform instrumental and laboratory examinations, in particular radiography, colonoscopy and ultrasound. Treatment in most cases is conservative, consisting of taking medications and following a diet.

Etiology

Partial intestinal obstruction occurs due to several reasons. The most common of these is the occurrence of adhesive disease in humans. The formation of adhesions, in turn, can be caused by several factors. For example, a consequence of an inflammatory process, trauma, cutting wound to the anterior wall of the abdominal cavity, or as a complication after surgery on the peritoneum. Adhesions lead to compression of a certain area of ​​the intestine, which interferes with the possibility of unhindered passage of feces.

Another predisposing factor for blockage of the intestinal lumen may be the formation of malignant and benign tumors on this organ. Sometimes neoplasms can be located outside the intestine and, as they grow, compress its loops. However, very often the formations are located from the inside, thereby closing its lumen.

In children, partial obstruction is caused by surgical operations on the abdominal cavity and pathologies of the structure of internal organs. A similar intestinal disease in newborns can be caused by a disorder such as intussusception. This is a pathological process during which the penetration of part of the large intestine into the small intestine or vice versa is observed.

Symptoms

The clinical manifestation of the disease will differ depending on the cause that caused its appearance. Thus, when adhesions form in the peritoneum, the symptoms are:

  • periodic appearance of pain in the abdominal area, of varying intensity;
  • disturbance of stool and gas production;
  • in some cases, vomiting occurs.

Such symptoms are not acute and in most cases go away on their own. Sometimes this can be helped by conservative treatment. But there is a high probability of their reappearance.

If the cause is a tumor, regardless of whether it is located inside or outside the intestine, the symptoms of partial intestinal obstruction are increasing. The main symptoms are similar to those above, only they can intensify when eating large amounts of junk food. Such symptoms tend to increase in intensity as the malignant or benign tumor increases in size.

Partial obstruction of the intestinal lumen may be followed by periods of heavy bowel movements. The stool will look like diarrhea, accompanied by a strong foul odor.

In the later stages of such a disease, the expression of so-called fecal vomiting is observed, in which the vomit has the smell of feces. This indicates a severe disruption of the functioning of the intestines. Often the clinical picture is complemented by peritonitis, in which a person suffers from constant profuse vomiting, after which no relief is observed. In such cases, severe exhaustion and dehydration of the body occurs.

The main feature of a partial blockage is that it can turn into a complete blockage at any time. Compression of blood vessels by numerous adhesions or a gradually enlarging tumor leads to the appearance of signs of acute intestinal obstruction.

Diagnostics

The basis of diagnostic measures for this disorder is laboratory and instrumental examinations of the patient. But before performing them, the gastroenterologist must independently carry out several measures:

  • study the patient’s life history and medical history to clarify the picture of the formation of the disease;
  • conduct a thorough survey and physical examination, which includes mandatory palpation of the abdomen, which will reveal the presence and intensity of symptoms. Digital examination reveals an empty rectum.

Laboratory diagnostic techniques consist of:

  • general and biochemical blood tests - to identify concomitant inflammatory processes, dysfunction of some internal organs, as well as changes in the composition of the blood;
  • microscopic examination of feces - to confirm or refute the presence of hidden hemorrhages;
  • general urine analysis.

Instrumental methods include:

  • radiography - carried out to detect specific signs of partial obstruction;
  • CT – for a more detailed assessment of the intestine;
  • Colonoscopy is an endoscopic procedure for examining the colon mucosa;
  • Ultrasound is the main method for confirming the diagnosis.

After receiving and studying all the examination results, the doctor prescribes the most effective treatment tactics and also decides to perform a surgical operation.

Treatment

Elimination of such a disease should be carried out in a medical institution, under the full supervision of doctors. First of all, conservative therapy is provided. In most cases, patients are prescribed:

  • taking or intravenously administering antispasmodics - this is done to eliminate pain;
  • substances to restore normal intestinal motility;
  • correction of water-salt balance using intravenous administration of drugs.

Conservative treatment is accompanied by performing siphon enemas and removing intestinal contents by introducing a special probe through the oral cavity.

In cases of ineffectiveness of such measures, surgical intervention is resorted to. In case of partial obstruction of the small intestine, excision of the affected organ is necessary, followed by anastomosis. If the cause of the disease is intussusception, manual or balloon disinvagination is performed. In cases of the formation of the disease against the background of adhesive disease, laparoscopy is indicated to dissect adhesions.

In case of partial obstruction of the large intestine due to a tumor, partial resection of the affected organ is performed, followed by removal of the large intestine to the anterior abdominal wall. This is necessary for the subsequent process of defecation.

Absolutely all operations are aimed at restoring the patency of feces and eliminating the main cause of the formation of such a disease.

In addition, the disease can be treated by following a diet or using traditional medicine. However, such methods are used only after preliminary consultation with the attending physician.

Similar materials

Dynamic intestinal obstruction (functional intestinal obstruction) is a disease that consists of a significant decrease or complete cessation of the activity of the affected organ without a mechanical obstacle to progress. During the development of the disease, stagnation of intestinal contents is often observed. Among other forms of intestinal obstruction, this occurs in every tenth patient. It affects people of any age group, so it is often diagnosed in children.

Intestinal obstruction (intestinal obstruction) is a pathological condition that is characterized by a violation of the movement of contents through the intestines, provoked by a failure in the process of innervation, spasms, obstruction or compression. It is worth noting that this disease is not an independent nosology - it usually progresses against the background of other gastrointestinal pathologies. The causes of intestinal obstruction are quite varied.

Paralytic intestinal obstruction is a pathological condition that is characterized by a gradual decrease in the tone and peristalsis of the human intestinal muscles. This condition is extremely dangerous, since without timely diagnosis and proper treatment, complete paralysis of the organ can occur. Paralytic intestinal obstruction is more often diagnosed in people from the middle and older age categories. The disease has no restrictions regarding gender or age category.

Obstructive intestinal obstruction is a pathological condition that is characterized by impaired movement of contents through the intestine due to compression of the mesentery. Develops due to partial or total blockage of the intestinal lumen. Factors that contribute to the development of obstructive obstruction can be both internal and external. It is also worth noting that depending on the root cause, the most effective treatment plan will be prescribed. As a rule, obstructive intestinal obstruction is eliminated surgically.

Strangulated intestinal obstruction is a dysfunction of the gastrointestinal tract, which is characterized not only by blockage of the intestine, but also by compression of the nerve fibers and vessels of the mesentery. This pathological condition is very dangerous, since the acute form of the disease in a short period of time can be complicated by necrosis of certain parts of the organ due to disruption of blood circulation in them. In medicine, there are cases where a person died within twelve hours from the initial expression of clinical signs.

Article rating:
1 star2 stars3 stars4 stars5 stars(No ratings yet)
Loading...
Share with friends:
Related publications