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Mary O’Reilly is a 55-year-old Woman Part 1 Small Bowel Obstruction Case Study GRADED A+
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Mary O’Reilly is a 55-year-old Woman Part 1 Small Bowel Obstruction Case Study GRADED A+
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Mary O’Reilly is a 55-year-old Woman Part 1 SmallBowel Obstruction Case Study GRADED A+
What is the dx when normal flow of intestinal contents is interrupted? - ANSWER:
Small bowel obstruction
Small bowel obstruction leads to dilation of stomach and small intestine proximal or
distal to blockage? - ANSWER: Proximal
When you have a small bowel obstruction distal to a blockage what happens? -
ANSWER: Bowel will decompress as contents are passed
What is the most frequent cause of small bowel obstruction? - ANSWER:
Postoperative adhesions and hernias (cause extrinsic compression of intestine)
In small bowel obstructions what causes intrinsic blockage? - ANSWER: Tumors or
strictures
True or False. Small bowel obstructions can be complete or partial. - ANSWER: True
What is the hallmark of small bowel obstruction? - ANSWER: Dehydration
When a pt has repeated bouts of nausea and emesis and typically cease taking in
food or liquids orally what kind of bowel obstruction does the pt have? - ANSWER:
Proximal bowel obstruction
As the small bowel dilates, it's blood flow can be compromised and lead to what? -
ANSWER: Necrosis or strangulation and sepsis
What are the most common symptoms in small bowel obstruction? - ANSWER:
Cramping abd pain and distention, vomiting, and inability to pass flatus
Pts with what kind of disease frequently presents with bowel obstruction due to
stricture? - ANSWER: Crohn's
What kind of overgrowth occurs in proximal small bowel?(Emesis can become
feculent) - ANSWER: Bacterial
What two symptoms are associated with strangulating bowel obstruction? -
ANSWER: Fever and tachycardia
What are some PE findings of small bowel obstruction? - ANSWER: Hypotension,
oliguria, and dry mucous membranes --> indicate dehydration.
Tenderness to light percussion, rebound, guarding, localized tenderness suggests
what in SBO? - ANSWER: Peritonitis
, Air filled loops of bowel of stomach in SBO is defined as what on percussion? -
ANSWER: Tympnay
True or False. Lab findings are helpful when determining presence of SBO. -
ANSWER: False... but can help in assessment of dehydration.
Presence of air in colon or rectum makes diagnosis of complete SBO more or less
likely? - ANSWER: Less likely
What diagnostic study is used to confirm diagnosis of SBO? - ANSWER: Plain abd x-
ray
What diagnostic study has replaced the small bowel series as the adjunctive study of
choice? - ANSWER: CT scan
What may be the appropriate diagnostic evaluation for a pregnant pt suspected of
SBO? - ANSWER: Ultrasound
How is SBO diagnosed? - ANSWER: Clinical and radiographic features
What is the initial management of SBO? - ANSWER: Determine degree of volume
depletion and metabolic derangement. Foley catheter to monitor urine output. IV
access for fluid resuscitation. Severity, cause and location of obstruction. Whether
nooperative mngt can be considered or need surgery. Swan-Ganz catheter for fluid
mngt (pts with hx of HF). Obstructed pts should be observed for no longer than 12-
24hrs.
Nonoperative mngt for SBO? - ANSWER: NG suction and IV fluids may be successful
in partial SBO
Operative mngt for SBO? - ANSWER: Nature of obstruction determines types and
extend of surgery. Important to handle dilated bowel proximal to point of
obstruction gently because bowel wall can be thing and easily injured. Adhesiolysis
best done with sharp scissors or cautery... etc.
How do you prevent SBO? - ANSWER: Laparoscopic surgery, when possible, appears
to lead to a decrease in frequency of postoperative adhesions.
What are the Functions of the Digestive Tract? - ANSWER: 1. Breakdown of food for
digestion
2. Absorption of nutrients produced by digestion into the bloodstream
3. Elimination of undigested foodstuffs and other waste products
4. Extends from mouth to anus
What are the Major Enzymes and Secretions? - ANSWER: Salivary amylase
HCL
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