The inability of intestinal contents to pass smoothly through the intestine is called intestinal obstruction. Intestinal obstruction is one of the common acute abdominal diseases in surgery, which is difficult to diagnose, develops rapidly and is serious, and often requires emergency management. After acute appendicitis, biliary tract diseases take the third place. The mortality rate of strangulated intestinal obstruction with severe disease still reaches about 10%.
Classification (a) according to the cause 1, mechanical intestinal obstruction: the most common, where the intestinal lumen is narrowed due to various reasons, thus making the passage of intestinal content obstructed. (1) Intestinal wall lesions, such as congenital intestinal atresia, stenosis, tumor, overlap, inflammation, etc. (2) Intestinal tube compression, such as adhesion band, intestinal torsion, incarcerated hernia, tumor compression, etc. (3) Intestinal lumen blockage, such as roundworm mass, fecal mass, gallstone, foreign body, etc.
2.Dynamic intestinal obstruction: where the muscle movement of the intestinal wall is disturbed due to neural inhibition or toxin stimulation, resulting in the inability of the intestinal contents to run, divided into two types of paralysis and spasticity. Paralytic is more common, and paralytic is the loss of peristaltic function of the intestinal tube, which can occur in acute diffuse peritonitis, after major abdominal surgery, retroperitoneal hematoma, and abdominal trauma. Spasticity is due to excessive and continuous contraction of intestinal wall muscles, which is relatively rare, such as chronic lead poisoning, acute enteritis, etc. can be seen.
3, hemodynamic intestinal obstruction: thrombosis or embolism of the mesenteric vessels, causing impaired blood circulation in the intestinal tube, resulting in intestinal paralysis, loss of peristaltic function, and inability of intestinal contents to run.
(B) According to the local lesion award intestinal obstruction is divided into simple and strangulated. If the blood flow of intestinal wall is normal and only the contents cannot pass, it is called simple intestinal obstruction, while the intestinal obstruction with blood flow obstruction of intestinal wall, such as intestinal torsion, intestinal entrapment, etc., often combined with mesenteric vascular compression is called strangulated intestinal obstruction, which will rapidly lead to intestinal wall necrosis and perforation, and then cause serious abdominal infection, systemic poisoning, toxic shock and high mortality.
(c) According to the site of obstruction, it can be divided into high intestinal obstruction, low small intestinal obstruction and colonic obstruction. If a section of intestinal collaterals are pressed at both ends causing obstruction, it is also called closed-collaterals type intestinal obstruction. The contents of the intestinal cavity cannot run up and down due to this type of obstruction, resulting in a highly distended intestinal cavity, thin intestinal wall and high tension, which makes it easy for necrosis and perforation of the intestinal wall. Therefore, closed-collar intestinal obstruction requires emergency treatment.
(iv) According to the degree of obstruction, it is divided into partial and complete intestinal obstruction.
(e) According to the urgency of the onset, it is divided into chronic and acute intestinal obstruction.
In order to facilitate the understanding of the disease and the need for treatment, intestinal obstruction is in continuous development and can be transformed under certain conditions. If intestinal obstruction is not treated in a timely and appropriate manner, the condition can rapidly develop and worsen, simple can become strangulated, incomplete can become complete, and mechanical can become paralytic.