Bowel obstruction

Share Print
Adresse

Switzerland

Christian Toso
Professor
Christian Toso
Head of Division

Bowel obstruction (or ileus) is defined as the abnormal cessation of the transit of gas and stool . Bowel obstruction occurs following the blockage (mechanical ileus) or paralysis (paralytic ileus) of the intestine. If the site of the obstruction is located in the small intestine, bowel obstruction is named small intestine ileus. If the site of obstruction is located in the colon, bowel obstruction is named colonic ileus. The diagnosis of bowel obstruction requires an abdominal CT scan.

The causes of this obstruction are multiple: a «cord» of fibrous tissue, scar adhesions (following a previous intervention or infection), hernias, cancers, drugs, and others.

Symptoms and risks related to intestinal obstruction

The symptoms of bowel obstruction are discontinuation of bowel transit, abdominal bloating, nausea, and vomiting. The content of the gastro-intestinal system, as well as its secretions, can no longer flow downwards into the digestive tract and end up by going back to the stomach.

The main risks are the inhalation of the digestive contents into the respiratory system (broncho-aspiration), as well as the necrosis of part of the digestive tract which can lead to perforation. To avoid these two complications, the immediate treatment consists in the insertion of a nasogastric tube in order to empty the stomach of its contents and to avoid broncho-aspiration.

Conservative or surgical treatment of intestinal obstruction

Depending on the cause of the obstruction and the presence or absence of severity factors, the surgeon can opt for conservative management (nasogastric tube and ingestion of radiological product) or for surgical treatment. The latter is usually done by laparotomy , due to the increase in the size of the digestive tract caused by the occlusion, but can sometimes be performed by laparoscopy , under general anesthesia. The removal of a segment of the intestine can sometimes be necessary. Then, depending on the patient's condition, the digestive tract may or may not be reconnected with, if necessary, a temporary or permanent ostomy .

Necrosis
×
Dead tissue
Nasogastric tube
×
Catheter passed through the nose to reach the stomach
Laparotomy
×
Open surgery of the abdomen
Laparoscopy
×
A surgical technique using small incisions and insertion of a camera
Ostomy
×
The surgical connection of a segment of the digestive tract to the skin outside its natural location.
INFO +  Ostomy
Last update : 23/07/2021