Red Flags: There's trouble down below

$3.95 		Nursing Made Incredibly Easy!
February 2005 
Volume 3  Number 1
Pages 60 - 62
 
  PDF Version Available!

ABSTRACT
Outline

  • Do not pass go

  • What's that sound?

  • Diagnostic tools

  • Treatment strategies

  • Up and at 'em

  • Types and causes of small bowel obstruction

  • Neurogenic

  • Mechanical

  • Vascular

  • Learn more about it



    Graphics

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    DIANE MILLS, 47, arrives at the emergency department (ED) complaining of intermittent moderate to severe crampy pain in her central abdomen that's lasted for several days. She'd also been nauseated and had vomited, but she hasn't vomited since yesterday. It's been a few days since her last bowel movement.

    Ms. Mills has a history of gall bladder surgery. After several years of suffering repeated attacks of gallstones, she underwent a traditional (nonlaparoscopic) cholecystectomy about a month ago.

    What's causing her current complaint?

    Figure. No caption available. Do not pass go

    Small bowel obstruction (SBO) is the most likely cause of the pain, nausea, and vomiting that Ms. Mills is experiencing. Postsurgical adhesions are by far the most common cause of mechanical SBO, followed by strangulated hernia, malignancy, Crohn's disease, and volvulus (twisted gut; this is rare). See Types and Causes of Small Bowel Obstruction for more information.

    In SBO, the intestine dilates above the blockage (proximal dilatation) due to an accumulation of gastrointestinal secretions and swallowed air. Vomiting is typically associated with obstruction closer to the upper portion of the small bowel.

    The distension of bowel tissue can cause lymphatic compression that leads to bowel wall lymphedema. Increasing pressure can result in reduced venous and arterial blood flow and severe ...

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