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Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. [2] [5] Either the small bowel or large bowel may be affected. [1] Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas. [1]
Neonatal bowel obstruction (NBO) or neonatal intestinal obstruction is the most common surgical emergency in the neonatal period. [1] It may occur due to a variety of conditions and has an excellent outcome based on timely diagnosis and appropriate intervention .
Sigmoid colon volvulus, also known as sigmoid volvulus, is volvulus affecting the sigmoid colon.It is a common cause of bowel obstruction [1] and constipation.It is common in Asia, India (7% of intestinal obstruction) and especially South India because of the high fibre diet.
Bowel obstruction may present with grumbling bowel sounds or high-pitched noises. Healthy persons can have no bowel sounds for several minutes [9] and intestinal contractions can be silent. [10] Hyperactive bowel sounds may be caused by partial or complete bowel obstruction as the intestines initially try to clear the obstruction. [11]
Volvulus causes severe pain and progressive injury to the intestinal wall, with accumulation of gas and fluid in the portion of the bowel obstructed. [11] Ultimately, this can result in necrosis of the affected intestinal wall, acidosis, and death. This is known as a closed-loop obstruction because there exists an isolated ("closed") loop of bowel.
Fecal vomiting occurs when the bowel is obstructed for some reason, and intestinal contents cannot move normally. Peristaltic waves occur in an attempt to decompress the intestine, and the strong contractions of the intestinal muscles push the contents backwards through the pyloric sphincter into the stomach, where they are then vomited.
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]
Decreased propulsive ability may be broadly classified as caused either by bowel obstruction or by intestinal atony or paralysis. However, instances with symptoms and signs of a bowel obstruction occur, but with the absence of a mechanical obstruction, mainly in acute colonic pseudo-obstruction, Ogilvie's syndrome. [3]