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Intestinal Obstruction I: Introduction01:29

Intestinal Obstruction I: Introduction

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Intestinal obstruction is a partial or complete blockage of the small or large intestine that disrupts the normal flow of intestinal contents through the lumen. This interruption impairs digestion, absorption, and fluid balance, and may lead to serious complications if not treated promptly.Mechanical ObstructionMechanical obstruction occurs when a physical blockage prevents intestinal contents from passing, arising from within the lumen or the bowel wall, or from external compression.Adhesions,...
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Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
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Intestinal obstruction triggers a series of physiological responses, starting with gas and fluid accumulation in the bowel segment proximal to the obstruction, leading to distension. This distended intestine compresses the diaphragm, hindering lung expansion and potentially leading to reduced respiratory effort, atelectasis, and pneumonia.To overcome the blockage, the gut intensifies contractions, causing colicky abdominal pain, nausea, and vomiting, which reduces fluid and food intake and...
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Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
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Bacterial gastroenteritis, characterized by diarrhea, abdominal cramps, and vomiting, is often caused by ingestion of contaminated food or water and is frequently associated with pathogenic Escherichia coli strains. These microbes exploit two principal mechanisms to inflict disease.Shiga toxin–producing E. coli, also referred to as STEC—notably O157:H7—release Shiga toxins that target ribosomes, blocking protein synthesis. The B subunit of the toxin binds the host glycolipid...
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Fecal impaction.

Zilla H Hussain1, Diana A Whitehead, Brian E Lacy

  • 1Division of Gastroenterology and Hepatology, Section of Gastroenterology and Hepatology, Dartmouth-Hitchcock Medical Center, Area 4C 1 Medical Center Drive, Lebanon, NH, 03756, USA, Zilla.H.Hussain@hitchcock.org.

Current Gastroenterology Reports
|August 15, 2014
PubMed
Summary
This summary is machine-generated.

Fecal impaction (FI) is a serious condition, often preventable, particularly in at-risk groups. Early diagnosis and treatment are crucial to avoid severe complications and reduce healthcare costs.

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Area of Science:

  • Gastroenterology
  • Colorectal Surgery
  • Geriatric Medicine

Background:

  • Fecal impaction (FI) is a prevalent and potentially severe condition affecting all age groups.
  • High-risk populations include children, incapacitated individuals, and institutionalized elderly patients.
  • FI often stems from chronic constipation, anorectal abnormalities, or gastrointestinal motility disorders.

Purpose of the Study:

  • To highlight the significance of early recognition and prompt management of fecal impaction.
  • To outline diagnostic approaches and treatment strategies for fecal impaction.
  • To emphasize preventive measures against fecal impaction recurrence.

Main Methods:

  • Comprehensive patient history and physical examination.
  • Diagnostic imaging, including abdominal series and computed tomography (CT) scans.
  • Therapeutic interventions such as manual disimpaction, enemas, rectal lavage, and contrast media administration.

Main Results:

  • Prompt identification and treatment of FI mitigate risks of serious complications like bowel obstruction, perforation, and cardiopulmonary collapse.
  • Various treatment modalities exist, ranging from conservative measures to surgical intervention for severe cases.
  • Preventive strategies are essential due to the commonality of FI recurrence.

Conclusions:

  • Fecal impaction requires vigilant recognition and timely intervention to prevent severe morbidity and mortality.
  • A multi-faceted approach combining diagnostic evaluation, effective treatment, and proactive prevention is key.
  • Long-term management should focus on lifestyle modifications and addressing underlying causes to minimize recurrence.