Overview of low level intestinal obstruction
Low intestinal obstruction is an intestinal obstruction in which the site of obstruction occurs in the ileum, colon, or rectum, and the intestinal contents do not pass through normally, and is more common with tumors, intestinal torsion, Crohn’s disease, and tuberculosis.
Questions you may be concerned about
Difference between high bowel obstruction and low bowel obstruction
According to the classification of obstruction site, intestinal obstruction can be divided into high intestinal obstruction and low intestinal obstruction, and the main difference between the two lies in the location of the onset of disease, clinical symptoms and other differences.
1. Different onset location: high intestinal obstruction mainly occurs in the intestinal area above the jejunum, while low intestinal obstruction usually refers to the obstruction of the ileum, colon and rectum.
2. Different clinical symptoms: high intestinal obstruction is high, the symptom of vomiting appears earlier and more frequently, and the vomit is mainly gastric and duodenal contents. Compared with high intestinal obstruction, vomiting in low intestinal obstruction appears later, with gastric contents at the beginning and fecal contents at the end.
In addition, abdominal distension is not obvious in high level obstruction, sometimes with gastric pattern, while abdominal distension is obvious in low level obstruction, with intestinal pattern and peristaltic wave, which may spread over the whole abdomen.
It is recommended that patients with intestinal obstruction should consult the doctor in time and actively cooperate with the doctor’s treatment. At the same time, they should develop good dietary habits and take appropriate exercise to promote the recovery of the disease.
Causes
It can often be caused by Crohn’s disease, intussusception, malignant tumor of the large intestine, diverticulum, fecal stone or foreign body obstruction, intestinal tuberculosis, sigmoid colon torsion and so on.
Symptoms
1. Symptoms
(1) Abdominal pain, characterized by paroxysmal abdominal cramps, which lasts for several minutes and is relieved after a few minutes, and may be painless in the intervals.
(2) Vomiting The vomiting of low intestinal obstruction appears late and little, at first it is gastric content, later the vomit is bilious liquid, and then it is brownish yellow intestinal fluid with foul smell. Fecal vomiting is often seen in low level small bowel obstruction.
(3) Abdominal distension appears later, but it is significant and spreads over the whole abdomen. In low small bowel obstruction, abdominal distension is mainly in the middle or lower abdomen. In the case of colonic obstruction, the whole abdomen is usually distended.
(4) Cessation of defecation Clinically, it is characterized by cessation of defecation.
(5) Systemic symptoms Vomiting is rare, and dehydration and electrolyte disorders are mild.
2. Physical signs
(1) Abdominal distension, visible gastrointestinal peristaltic wave and intestinal pattern.
(2) Abdominal tenderness, drumming on percussion, high-pitched bowel sounds or gas over water sounds on auscultation, and high-pitched metallic sounds are seen in large amounts of gas in the intestines.
Examination
1. Laboratory examination
Decreased electrolytes and metabolic acidosis may be seen.
2. Stereo X-ray of the abdomen
On X-ray film, the dilated intestinal collaterals of low small bowel obstruction are in the middle of the abdomen, arranged in a step-like fashion, and there is no accumulation of gas in the colon.
3.CT examination
It can identify the cause and location of intestinal obstruction.
Diagnosis
1. Diagnosis can be made on the basis of history and clinical manifestations such as abdominal pain, vomiting, abdominal distension and cessation of defecation and gas evacuation.
2. Abdominal standing X-ray film has important diagnostic value.
Treatment
1. Non-surgical treatment
(1) Prohibit drinking and fasting, and give the patient gastrointestinal decompression.
(2) Correct the imbalance of water, electrolyte and acid-base balance. Give patients nutritional support when necessary.
(3) Apply broad-spectrum antibiotics and combine with antibiotics targeting anaerobic bacteria for anti-infective treatment to prevent or treat abdominal or lung infections.
(4) Give patients sedative, analgesic and antispasmodic drugs according to the needs of the condition, but the application of analgesics should follow the principles of acute abdomen treatment.
(5) Traditional Chinese medicine treatment.
2. Surgical treatment
(1) Applicable to the ineffective non-operative treatment, congenital intestinal atresia and intestinal tumors.
(2) Surgical methods include caesarean section, intestinal stoma or intestinal externalization, and intestinal short-circuit anastomosis.