Bowel obstruction

Bowel obstruction is mechanical blockage of the intestines, preventing the normal transit of the products of digestion. It can occur at any level in the digestive tract, and is a medical emergency. Although many cases are not treated surgically, it is a surgical problem.

Causes

Small bowel obstruction

Causes of small bowel obstruction include:

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• Adhesions from previous abdominal surgery
• Hernias containing bowel
• Neoplasms, benign or malignant
• Inflammatory bowel disease causing adhesions or inflammatory strictures
• Intususseption in children
• Volvulus
• Ischaemic strictures
• Foreign bodies (e.g. gallstones in gallstone ileus, swallowed objects)

Large bowel obstruction

Causes of large bowel obstruction include:

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• Neoplasms
• Hernias
• Inflammatory bowel disease
• Sigmoid or caecal volvulus
• Faecal impaction

Differential diagnosis

Differential diagnoses of bowel obstruction include:

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• Ileus
• Pseudo-obstruction, or Ogilvie's syndrome
• Intra-abdominal sepsis
• Pneumonia or other systemic illness.