[Principles of differential diagnosis and strategy in acute intestinal obstruction]

Intestinal obstruction is diagnosed as one of two kinds--small intestine and large intestine obstruction. They differ in etiology of the obstacle, pathogenesis and degree of clinical picture. The cause of the small intestine obstruction in patients having laparotomy in medical history is the formation of commissures. In patients with intact abdomen the cause of low obstruction was torsion and intussusception, the cause of high obstruction was the obturation with a bile calculus and a foreign body. Causes of the large intestine obstruction were obturation with a tumor and torsion. Napalkov's test is expedient but when suspecting the small intestine obstruction. Conservative treatment is possible in commissural small intestine obstruction (12-24 h) and in large intestine obturation obstruction (not longer than 2h).