The primary and most life-threatening complication of a bowel obstruction is strangulation, which leads to bowel ischemia (loss of blood supply) and subsequent tissue death (gangrene).
Intestinal obstruction can cut off the blood supply to part of your intestine. Lack of blood causes the intestinal wall to die. Tissue death can result in a tear (perforation) in the intestinal wall, which can lead to infection.
Bowel obstructions usually cause cramping abdominal pain, vomiting and inability to pass bowel motions (faeces or poo) or gas.
Strangulation is the most severe complication of small bowel obstruction and is a surgical emergency. This occurs when bowel wall edema compromises perfusion to the intestine and necrosis ensues. This will eventually lead to perforation, peritonitis and death if not intervened upon.
The complications of a bowel obstruction are life-threatening without emergency care. Perforation and infection: The fluids, gases and digestive juices that build up behind the obstruction can create ballooning pressure that causes your intestine to tear (perforation).
Get medical help right away if you have symptoms of intestinal obstruction. These include severe abdominal pain, vomiting, and inability to pass stool.
Without any fluids (either as sips, ice chips or intravenously) people with a complete bowel obstruction most often survive a week or two. Sometimes it's only a few days, sometimes as long as three weeks. With fluids, survival time may be extended by a few weeks or even a month or two.
Abdominal Pain and Cramping
Abdominal pain or cramping is a common symptom. The pain can be mild or very severe. It may stay the same or change. This pain happens because the bowel tries to move stuff past the blockage.
SBO presents with hallmark symptoms of abdominal pain, vomiting, distension, and obstipation. The pathophysiology includes bowel distension, impaired venous return, mucosal ischemia, bacterial translocation, and, in severe cases, necrosis, perforation, and peritonitis.
The most common cause of large bowel obstruction is colorectal cancer, accounting for 50-70% of presentations. o For colorectal cancer, large bowel obstruction is the clinical presentation in 10% of cases. o Obstruction from tumors distal to the splenic flexure are most common (75%).
The most common symptoms of fecal impaction are as follows: Abdominal pain (often after meals) The ongoing urge to pass stool. Liquid stool (most often means stool is leaking around the impacted mass)
Clinical Features
Patients with bowel obstruction will present with the cardinal features of bowel obstruction (to varying degrees): Abdominal pain – colicky or cramping in nature (secondary to the bowel peristalsis) Vomiting – occurring early in proximal obstruction and late in distal obstruction. Abdominal distension.
The 3-6-9 rule is a guideline for interpreting abdominal X-rays to detect bowel obstruction, stating normal upper limits are 3 cm for the small bowel, 6 cm for the large bowel (colon), and 9 cm for the cecum; diameters exceeding these suggest dilation, a key sign of obstruction, with larger measurements increasing the risk of rupture (e.g., >6cm small bowel, >9cm cecum).
Symptoms of a bowel perforation include:
According to the site of obstruction, mechanical bowel obstruction can be classified as: Large bowel obstruction (LBO): obstruction at the level of the cecum, colon, or rectum. Small bowel obstruction (SBO): obstruction at the level of the duodenum, jejunum, or ileum.
Symptoms of bowel obstruction include: abdominal pain. abdominal cramps. swelling, or distension, of the abdomen.
Serious causes of bowel problems
For example, no bowel sounds after a period of hyperactive bowel sounds can mean there is a rupture of the intestines, or strangulation of the bowel and death (necrosis) of the bowel tissue. Very high-pitched bowel sounds may be a sign of early bowel obstruction.
Treating partial bowel obstruction
No matter what type of bowel obstruction, you will likely be sent to the hospital to receive medication and fluids through an IV to start. Your doctor may insert a nasogastric tube through your nose and into your stomach to remove built up fluids and gas.
Clinicians should consider a foreign body or bezoar in the differential for unexplained intermittent bowel obstruction symptoms. Phytobezoars can occur from undigested plant or food material, and generally require endoscopic evaluation for diagnosis and potential treatment.
Bowel obstruction end of life symptoms often include severe abdominal pain, nausea, vomiting, bloating, and an inability to pass stool or gas. These issues are frequently linked to colon cancer or tumors that block the intestines. Prompt management can greatly reduce discomfort and distress.
Common symptoms include: Abdominal cramping and bloating. Leakage of liquid or sudden episodes of watery diarrhea in someone who has chronic (long-term) constipation. Rectal bleeding.
Common signs and symptoms of a twisted colon include the following: