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Intestinal obstruction


Definition:

Intestinal obstruction is a partial or complete blockage of the bowel. The contents of the intestine cannot pass through it.

Alternative Names:

Paralytic ileus; Intestinal volvulus; Bowel obstruction; Ileus; Pseudo-obstruction - intestinal; Colonic ileus

Causes:

Obstruction of the bowel may due to:

  • A mechanical cause, which means something is in the way
  • Ileus, a condition in which the bowel does not work correctly, but there is no structural problem causing it

Paralytic ileus, also called pseudo-obstruction, is one of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include:

  • Bacteria or viruses that cause intestinal infections (gastroenteritis)
  • Chemical, electrolyte, or mineral imbalances (such as decreased potassium levels)
  • Complications of abdominal surgery
  • Decreased blood supply to the intestines (mesenteric ischemia)
  • Infections inside the abdomen, such as appendicitis
  • Kidney or lung disease
  • Use of certain medicines, especially narcotics

Mechanical causes of intestinal obstruction may include:

Symptoms:
Exams and Tests:

During a physical exam, the health care provider may find bloating, tenderness, or hernias in the abdomen.

Tests that show obstruction include:

Treatment:

Treatment involves placing a tube through the nose into the stomach or intestine. This is to help relieve abdominal swelling (distention) and vomiting. Volvulus of the large bowel may be treated by passing a tube into the rectum.

Surgery may be needed to relieve the obstruction if the tube does not relieve the symptoms. It may also be needed if there are signs of tissue death.

Outlook (Prognosis):

The outcome depends on the cause of the blockage. Most of the time, the cause is easily treated.

Possible Complications:

Complications may include or may lead to:

If the obstruction blocks the blood supply to the intestine, it may cause infection and tissue death (gangrene). Risks for tissue death are related to the cause of the blockage and how long it has been present. Hernias, volvulus, and intussusception carry a higher gangrene risk.

In a newborn, paralytic ileus that destroys the bowel wall (necrotizing enterocolitis) is a life-threatening condition. It may lead to blood and lung infections.

When to Contact a Medical Professional:

Call your health care provider if you:

  • Cannot pass stool or gas
  • Have a swollen abdomen (distention) that does not go away
  • Keep vomiting
Prevention:

Prevention depends on the cause. Treating conditions, such as tumors and hernias that can lead to a blockage, may reduce your risk.

Some causes of obstruction cannot be prevented.

References:

Fry RD, Mahmoud N, Maron DJ, Bleier JIS. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. St. Louis, MO: WB Saunders; 2012:chap 52.

McKenzie S, Evers BM. Small intestine. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. St. Louis, MO: WB Saunders; 2012:chap 50.

Turnage RH, Heldmann M. Intestinal obstruction. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, PA: Saunders Elsevier; 2010:chap 119.


Review Date: 8/11/2014
Reviewed By: Jenifer K. Lehrer, MD, Department of Gastroenterology, Frankford-Torresdale Hospital, Aria Health System, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. Copyright 2002 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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