How is intestinal obstruction diagnosed?

Written by Li Jin Quan
General Surgery
Updated on September 04, 2024
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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.

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Symptoms of intestinal obstruction

For symptoms of intestinal obstruction, the typical manifestations are abdominal pain, bloating, vomiting, and cessation of passing gas or stool. Most people may experience several of these symptoms; however, the severity of the symptoms depends on the location and condition of the obstruction. Once symptoms of intestinal obstruction occur, it is necessary to refrain from eating and then carry out appropriate examinations. Identifying the cause of the obstruction is crucial. If the obstruction is caused by tumor-related factors, surgical treatment should be considered based on a comprehensive assessment. If the obstruction is due to adhesions, conservative treatment methods should be adopted where possible.

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Causes of intestinal obstruction

Generally, the basic causes of intestinal obstruction can be divided into three categories. The most common is mechanical intestinal obstruction, which mainly includes blockage of the intestinal lumen, such as large fecal masses or corresponding foreign objects, and even parasites. The second type is compression of the intestinal tube, which can be caused by adhesions leading to torsion of the intestine or compression by tumors, and congenital inflammatory strictures and tumors can cause mechanical intestinal obstruction. The second major category is dynamic intestinal obstruction, which is primarily due to weakened peristaltic ability of the intestine, resulting in paralytic intestinal obstruction. This condition can be improved by adjusting intestinal function disorders or treating intestinal spasms. The third type is intestinal obstruction caused by vascular issues in the intestines, most commonly thrombosis of the mesentery or compression causing vascular disorders of the intestines.

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Does intestinal obstruction cause fever?

It is possible, as the primary pathophysiological change in intestinal obstruction is the translocation of intestinal flora causing infection, which can lead to symptoms such as fever. Therefore, fever is also a factor in assessing the condition. If a patient has persistent high fever, they may even develop septic shock, which could necessitate surgical intervention such as exploratory laparotomy. Thus, fever is a common factor in intestinal obstruction, but it is not a mandatory one.

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Is intestinal obstruction dangerous?

Whether intestinal obstruction is dangerous depends on the actual individualized level. If the obstruction has progressed to symptoms of peritonitis, and if intestinal necrosis cannot be ruled out, not performing timely exploratory laparotomy surgery could potentially endanger the patient's life. However, if it is just a mild incomplete obstruction, with signs of passing gas and stools, and the patient’s abdominal symptoms are not pronounced, and related examinations are not concerning, then the risk to the patient might be relatively smaller. Therefore, in such cases, it is not possible to generalize, and decisions need to be made based on the individual situation.

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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.