1, according to the causes of obstruction 1, mechanical intestinal obstruction: mechanical factors cause the narrowing of the intestinal cavity or inaccessible, resulting in the intestinal contents can not pass, is the most common type of I clinical. Common causes include: ① extra-intestinal factors, such as adhesions and belt compression, hernia impaction, tumor compression, etc.; ② intestinal wall factors, such as intestinal overlap, intestinal torsion, congenital malformation, etc.; ③ intestinal lumen factors, such as roundworm obstruction, foreign body, fecal mass or gallstone blockage.
2, power intestinal obstruction: it is divided into two categories: paralytic and spastic, which are disorders of intestinal wall muscle movement due to neural inhibition or toxin stimulation, but no organic intestinal lumen narrowing. Paralytic intestinal obstruction is more common and occurs in patients after laparotomy, abdominal trauma, or diffuse peritonitis due to severe neurological, humoral, and metabolic (e.g., hypokalemia) alterations. Spastic intestinal obstruction is less common and can occur in patients with acute enterocolitis, intestinal dysfunction or chronic lead poisoning.
3, hemodynamic intestinal obstruction: due to mesenteric vascular embolism or thrombosis, so that the intestinal blood flow obstruction, loss of peristaltic capacity, although the intestinal lumen is not obstructed, but the intestinal contents stop running, so it can also be classified as dynamic intestinal obstruction. But because it can be rapidly followed by intestinal bad.
4, unknown cause of pseudo-intestinal obstruction and paralytic intestinal obstruction is different, no obvious cause, is a chronic disease, but also can be a genetic disease, but it is not clear whether the intestinal smooth muscle or intestinal wall nerve plexus abnormalities. Patients have intestinal peristalsis, abdominal pain, vomiting, bloating, diarrhea and even steatorrhea, with diminished or normal bowel sounds.
The treatment of pseudo-intestinal obstruction is mainly non-surgical, and surgical treatment is only performed when it is complicated by perforation and necrosis. Parenteral nutrition is a method to treat such patients.
Classification according to the presence or absence of blood flow obstruction in the intestinal wall 1.Simple intestinal obstruction: only the passage of intestinal contents is obstructed, and there is no blood flow obstruction in the intestinal tube.
2. Strangulated intestinal obstruction: acute ischemia of the corresponding smooth segment due to compression of mesenteric vessels or small vessels of intestinal wall, embolism of vascular lumen or thrombosis, causing intestinal necrosis and perforation.
Third, according to the classification of obstruction site can be divided into high small intestine (jejunum) obstruction, low small intestine (ileum) obstruction and colonic obstruction. The latter can only enter the colon from the small intestine because of the role of the ileocecal valve, and cannot return, so it is also called “closed-collar obstruction”. Any section of intestinal collaterals completely blocked at both ends, such as intestinal torsion, are closed-collar obstruction.
Fourth, according to the degree of obstruction classification can be divided into complete and incomplete intestinal obstruction. According to the development of the disease process, it is also divided into occult and chronic intestinal obstruction. Chronic incomplete intestinal obstruction is simple intestinal obstruction, while acute complete intestinal obstruction is mostly strangulated.
The above classifications can be transformed into each other in the changing pathological process. For example, simple intestinal obstruction can develop into strangulated if the treatment is not indolent; mechanical intestinal obstruction can develop into paralytic intestinal obstruction due to excessive dilatation of the intestinal canal above the obstruction if the time is too long; chronic incomplete intestinal obstruction can become acute complete high obstruction due to inflammatory edema, and the pathophysiological changes that occur in the late stage of low obstruction can also occur.