How is intestinal obstruction treated?

Written by Li Jin Quan
General Surgery
Updated on August 31, 2024
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The treatment methods for intestinal obstruction can be divided into non-surgical and surgical treatments in clinical practice. In our clinic, most cases of intestinal obstruction, such as adhesive obstruction or parasitic obstruction, can be alleviated through gastrointestinal decompression, enemas, and rapid expulsion of gas and stools, achieving the therapeutic goal. However, a small portion of intestinal obstructions do not respond to non-surgical treatments, and vital signs cannot be maintained; such cases require active surgical intervention.

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Causes of intestinal obstruction

The causes of intestinal obstruction include factors external to the intestine and those originating from the intestine itself. External factors are mainly adhesions and bands of adhesions that cause intussusception or volvulus, thereby leading to intestinal obstruction. Congenital adhesive bands are common in children. Adhesions resulting from abdominal surgery or intra-abdominal inflammatory lesions are the most common causes of adult intestinal obstruction, although a minority of patients may have no history of abdominal surgery or inflammation. Additionally, incarcerated external or internal hernias may also cause intestinal obstruction. Furthermore, tumors external to the intestine or abdominal compression can also lead to obstruction.

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Intestinal obstruction complications

The complications of intestinal obstruction include some common clinical symptoms such as abdominal pain, distension, nausea, vomiting, and cessation of passing gas or stool from the anus. The initial symptom in complications is electrolyte imbalance, which is caused by the inability to eat and frequent vomiting. Another issue is the displacement of intestinal flora due to the obstruction, which can lead to infections. This is why it’s essential for patients with intestinal obstruction to actively undergo antibiotic treatment. The most severe complication is that a serious intestinal obstruction can lead to necrosis of the intestine. Based on this necrosis, a patient can develop septic shock or toxic shock, which are life-threatening conditions.

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Principles of Intestinal Obstruction Treatment

In the treatment principles of intestinal obstruction, the basic treatment methods apply to both partial and complete intestinal obstructions. Firstly, gastrointestinal decompression is required based on the situation. Gastrointestinal decompression involves the insertion of a gastric tube, which is determined by whether the patient has symptoms of nausea and vomiting. If these symptoms are prominent, a gastric tube should be placed to drain the stomach contents, thus alleviating the burden and swelling of the intestines and aiding in the treatment of the disease. Another aspect is fluid replenishment and anti-inflammation, as intestinal obstruction will definitely lead to changes in intestinal flora and concurrent infections, making anti-infection measures very important. Fluid replenishment involves administering nutrient solutions to provide nutrition and prevent electrolyte imbalances. Additionally, enemas or traditional Chinese medicine may be used to facilitate intestinal motility. During this treatment process, it is crucial to closely monitor the condition to assess if exploratory surgery is indicated. As the condition can either improve or worsen, close observation is extremely important.

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Written by Li Jin Quan
General Surgery
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Symptoms of intestinal obstruction

Intestinal obstruction is caused by any factor that causes blockage of the intestinal tube. Compression and twisting cause the intestinal contents to not pass normally, leading to obstructive symptoms. Clinically, intestinal obstruction mainly presents with four major symptoms: first, intermittent abdominal pain; second, vomiting, where the higher the location of the obstruction, the earlier and more frequent the vomiting, consisting mainly of food or gastric fluid. If the location of the obstruction is lower, the vomiting is delayed and less frequent and may include fecal matter; third, abdominal distension, which generally occurs after the obstruction has been present for some time, and its severity is related to the location of the obstruction; fourth, cessation of gas and feces discharge through the anus.

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How is intestinal obstruction diagnosed?

The main clinical manifestations of intestinal obstruction include abdominal pain, abdominal distension, vomiting, and cessation of gas and bowel movements from the anus. During the physical examination, tenderness in the abdomen can be observed, as well as hyperactive bowel sounds. Laboratory tests may reveal increased red and white blood cell counts, and electrolyte imbalances. Supplementary examinations, such as abdominal X-ray films, can show dilation of the intestinal tube, air and fluid accumulation within the abdominal cavity, and the presence of fluid-air levels. Abdominal ultrasound can also reveal air and fluid accumulation in the intestinal tube. Through the above examinations, intestinal obstruction can be diagnosed.