ACUTE ORGANIC SMALL BOWEL OBSTRUCTION
Essentials of Diagnosis
• Colicky abdominal pain, vomiting, constipation borborygmus.
• Tender distended abdomen.
• Audible peristalsis.
• X-ray evidence of gas or multiple gas and fluid levels without movement of gas.
• Little or no leucocytosis.
a. Decompression by nasogastric suction.
b. Correction of fluid, electrolyte and colloid deficit.
c. Broad spectrum antibiotic if strangulation is
suspected (i.e. Gentamicin/Ampicillin IM/IV Metrogyl)
-Fever, leucocytosis, abdominal rigidity/ascites, blood in the faeces means strangulation and immediate surgery is essential.
-If in an uncomplicated case with adequate decom- pression pain does not subside and flatus does not pass, operation is inevitable. Surgery consists of relieving the obstruction and removal of gan- grenous bowel with reanastomosis.