Overview of high level intestinal obstruction
High intestinal obstruction is an obstruction in the duodenum or jejunum, causing obstruction to the passage of intestinal contents. The obstruction is high, vomiting is frequent and occurs early, and most of the vomit is gastric and duodenal contents, with abdominal distension not obvious.
Questions you may be concerned about
What are the feces of high intestinal obstruction
High intestinal obstruction is an intestinal obstruction that occurs when the obstruction is in the duodenum or jejunum, causing obstruction to the passage of intestinal contents. Because of the high obstruction site, vomiting is frequent and occurs early, and most of the vomit is gastric and duodenal contents, and abdominal distension is not obvious. The feces of high intestinal obstruction, which is defined as feces located below the site of obstruction prior to obstruction, requires active treatment to relieve the intestinal obstruction to improve clinical symptoms.
In high-grade intestinal obstruction, the patient will also expel gas and feces below the obstruction site in the pre-obstruction stage; in the late stage of obstruction, the anus will stop defecating and exhausting gas.
When high intestinal obstruction occurs, you need to actively cooperate with the doctor to receive treatment, common treatment options include non-surgical treatment and surgical treatment, you need to take into account your own specific situation, choose the most suitable treatment option.
Difference between high and low intestinal 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 onset, 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 do proper exercise to promote the recovery of the disease.
Causes
1. Congenital diseases, such as annular pancreas, duodenal atresia and so on.
2. Occupying lesions, such as carcinoma of pot belly, tumor of upper jejunum, etc.
3. Postoperative anastomotic stenosis of gastroduodenum or upper jejunum.
4. Foreign body in the intestinal tube.
5. Extra-intestinal compressive diseases, such as intra-abdominal adhesions, duodenal stasis.
6.Others.
Symptoms
1.Symptoms
(1) Abdominal pain Upper abdominal distension and discomfort, epigastric distension or mild paroxysmal colic soon after eating, which can be relieved by vomiting.
(2) Abdominal distension Abdominal distension is not obvious, but sometimes a gastric pattern is seen.
(3) Vomiting Vomiting appears early and can occur a short time after obstruction, vomiting is frequent, and the vomit is gastric and duodenal contents. The pain is relieved after vomiting.
(4) Anus stops defecation and evacuation In the early stage of obstruction, the accumulated gas and feces can still be evacuated, therefore, the possibility of intestinal obstruction cannot be ruled out even if there is defecation and evacuation after abdominal pain.
(5) Systemic manifestations Weak pulse, electrolyte and acid-base balance imbalance; malnutrition, emaciation, mental depression, or even combined with infection, shock, and death.
2. Physical signs
(1) Flat abdomen or only epigastric distension.
(2) Pressure and pain in the epigastric region, abdominal mass, weakened bowel sounds on auscultation, and sometimes vibratory water sounds in the epigastric region.
Examination
1. Laboratory examination
Low potassium, low chlorine, metabolic acidosis may occur.
2. Abdominal X-ray barium examination
Gastroduodenal stasis, dilatation, barium can be suddenly interrupted somewhere in the duodenum, and sometimes reverse peristalsis can be seen.
3. Endoscopy and CT examination
The cause and location of obstruction can be identified.
Diagnosis
1. Diagnosis can be confirmed according to history, clinical manifestations and imaging examination.
2. Abdominal X-ray barium examination has important diagnostic value.
Treatment
1. Non-surgical treatment
(1) Abstain from drinking and fasting, and give the patient gastrointestinal decompression.
(2) Correct the imbalance of water, electrolyte and acid-base balance. According to the clinical manifestations, combined with the electrolyte and arterial blood gas analysis results, carry out rehydration to correct the imbalance of water, electrolyte and acid-base balance. Give the patient nutritional support when necessary.
(3) Apply broad-spectrum antibiotics, and co-apply 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.
2. Surgical treatment
Applicable to non-surgical treatment is ineffective or tumor lesions.
Prevention
1. Pay attention to dietary hygiene, avoid overeating.
2. Avoid eating cold, greasy and sticky food; choose easily digestible plant food containing much fiber, eat less animal food; food processing or cooking should be fine to facilitate chewing; animal food should be cooked and eaten to facilitate digestion and absorption.
3. Keep the bowel movement smooth every day.
4. Prohibit activities and strenuous exercise after meals.
5. Seek medical advice promptly if you have abdominal distension, abdominal pain or other discomforts.