Intestinal obstruction is a common surgical acute condition. The disease is critical, complex and variable. Clinical manifestations Abdominal pain: mechanical intestinal obstruction manifests as paroxysmal abdominal colic, which is caused by the intensification of intestinal peristalsis to overcome the obstruction. If the interval of abdominal pain keeps shortening, or even becomes persistent, it may be a manifestation of strangulated intestinal obstruction. Vomiting: In the early stage of intestinal obstruction, vomiting is reflexive, and the vomit is food or gastric juice; it is generally believed that the higher the obstruction site, the earlier and more frequent vomiting appears; while in low obstruction and colonic obstruction, vomiting appears late and rarely; the vomit may be fecal-like. Abdominal distension: appears later. Abdominal distension is not obvious in high intestinal obstruction, but is obvious in low intestinal obstruction and colonic obstruction. Anal cessation of defecation: After the occurrence of complete intestinal obstruction, patients mostly do not defecate. However, a few patients still have residual stool and gas below the obstruction, which can still be expelled, so the existence of intestinal obstruction cannot be denied for this reason.
The physical examination usually shows an acute painful face, and the early vital signs generally do not change much. In the late stage, elevated body temperature, shortness of breath, decreased blood pressure and increased pulse rate may be observed. Abdominal signs may include intestinal pattern, peristaltic waves, abdominal pressure pain, rebound pain and muscle tension after the appearance of strangulation. In some patients, a mass may be palpable in the abdomen. In strangulated intestinal obstruction, ascites may appear, and mobile turbid sounds may be heard on percussion. Auscultation: mechanical intestinal obstruction may present with hyperactive bowel sounds and air-over-water sounds. In strangulated intestinal obstruction, the bowel sounds are diminished or absent.
Intestinal obstruction can be broadly divided into two categories: mechanical (organic) and dynamic (functional).
1, mechanical intestinal obstruction is caused by intestinal blockage due to organic lesions in the intestine or outside the intestine. The etiology can be congenital developmental malformations such as intestinal atresia, intestinal stenosis, poor intestinal rotation, annular pancreas, hernia impaction, etc. Acquired causes include intestinal overlap, blockage by roundworm mass, intestinal torsion, tumor compression, inflammation or post-surgical intestinal adhesions, etc.
2.Functional intestinal obstruction is due to poor intestinal peristaltic function so that the intestinal contents cannot be delivered and transported normally. It is common in various kinds of severe pneumonia, sepsis, enteritis caused by toxic intestinal paralysis or paralytic intestinal obstruction caused by low blood potassium. Or congenital megacolon and pyloric hypertrophic obstruction caused by abnormal development of the intestinal nerves.
If there is no history of surgery, the occurrence may be due to long-term habitual constipation, and if the habit of constipation is still maintained after treatment, there is still a chance of getting it again. Pay attention to keep the habit of regular bowel movement and the time spent on bowel movement should not be too long. Intestinal obstruction is a relatively common acute abdominal disease in pediatrics.