What are expected findings in a small bowel obstruction?

The patient with a small bowel obstruction will usually present with abdominal pain, abdominal distension, vomiting, and inability to pass flatus. In a proximal obstruction, nausea and vomiting are more prevalent. Pain is frequently described as crampy and intermittent with a simple obstruction.

What are the physical findings of bowel obstruction?

History and Physical Examination

The hallmarks of intestinal obstruction include colicky abdominal pain, nausea and vomiting, abdominal distension, and a cessation of flatus and bowel movements.

What are the signs and symptoms of small bowel obstruction?

How can you tell the difference between a small and large bowel obstruction?

Small and large bowel obstruction have many overlapping symptoms. However, quality, timing, and presentation differ. Commonly in SBO, abdominal pain is described as intermittent and colicky but improves with vomiting, while the pain associated with LBO is continuous.

What is the most common complication of small bowel obstruction?

Hernias — probably the most common condition in children and adults, in which a small part of the intestine protrudes through another part of the body.

Small Bowel Obstruction (SBO) | Risk Factors, Causes, Signs

What are the four cardinal features of intestinal obstruction?

The four cardinal symptoms of bowel obstruction are pain, vomiting, obstipation/absolute constipation, and distention.

What bowel sounds are heard with bowel obstruction?

Contemporary textbooks often state that hyperactive, tinkling, metallic or high-pitched bowel sounds are characteristic clinical findings in patients with bowel obstruction[5-8], but the evidence supporting the clinical utility of these findings is sparse.

What is the focused assessment for small bowel obstruction?

Diagnosis for an SBO is determined with a combination of tests. A physical exam, abdominal X-ray, CT scan, ultrasound, and barium enemas are used to determine if the small bowel is obstructed and where exactly the blockage is. Patients are hospitalized to rest the bowel, with NPO status and IV fluids.

What assessment findings are normal related to bowel elimination?

Bowel Elimination Assessment

A normal pattern is typically one bowel movement every one to three days with stools having a soft or formed consistency.

What are the 4 types of bowel sounds?

Are bowel sounds absent in bowel obstruction?

In patients with small bowel obstruction, clinical observation shows that approximately 40% have hyperactive bowel sounds and approximately 25% have diminished or absent bowel sounds.

Does small bowel obstruction cause hyperactive bowel sounds?

Physical Examination

The duodenal or proximal small bowel has less distention when obstructed than the distal bowel has when obstructed. Hyperactive bowel sounds occur early as gastrointestinal (GI) contents attempt to overcome the obstruction; hypoactive bowel sounds occur later in the disease process.

What is the chief complaint of bowel obstruction?

Major complaints in patients with large-bowel obstruction (LBO) include abdominal distention, nausea, vomiting, and crampy abdominal pain. An abrupt onset of symptoms makes an acute obstructive event (eg, cecal or sigmoid volvulus) a more likely diagnosis.

What is the most commonly occurring small intestinal obstruction?

Practice Essentials. Small-bowel obstruction (SBO) is caused by a variety of pathologic processes. The most common cause of SBO in developed countries is intra-abdominal adhesions, accounting for approximately 65% to 75% of cases, followed by hernias, Crohn disease, malignancy, and volvulus.

What is the most common of small intestinal obstruction?

Small bowel obstructions are usually caused by scar tissue, hernia, or cancer. In the United States, most obstructions occur as a result of prior surgeries. The bowel often forms bands of scar (called adhesions) after being handled during an operation.

What are normal findings for bowel sounds?

Normal: Bowel sound consist of clicks and gurgles and 5-30 per minute. An occasional borborygmus (loud prolonged gurgle) may be heard.

Does bowel obstruction show up on CT scan?

Bowel obstruction is considered to be present at CT when distended bowel loops are seen proximal to collapsed loops.

Where is the best place to hear bowel sounds?

Place the diaphragm of your stethoscope lightly over the right lower quadrant and listen for bowel sounds. If you don't hear any, continue listening for 5 minutes within that quadrant. Then, listen to the right upper quadrant, the left upper quadrant, and the left lower quadrant.

What does no bowel sounds indicate?

Absent bowel sounds are a cue that suggest there may be a problem with the movement of contents through the intestines: common causes include peritonitis , a complete bowel obstruction, or perforation of the small or large intestine.

What does sluggish bowel sounds mean?

They are a sign that intestinal activity has slowed. Hypoactive bowel sounds are normal during sleep. They also occur normally for a short time after the use of certain medicines and after abdominal surgery. Decreased or absent bowel sounds often indicate constipation.

What does percussion of the abdomen tell you?

Percussion of the abdomen involves tapping the body to elicit sounds and determining whether the sounds are appropriate for the underlying structure of the quadrant. This provides information about the overall consistency of the abdomen as well as the size and borders of some of the underlying structures.

What are the radiological findings in small bowel obstruction?

Signs of small- bowel obstruction on radiographs include dis- tended loops of bowel greater than 3 cm, col- lapsed colon, differential air–fluid levels, and thickened bowel wall (Fig. 1). The string-of- pearls sign may also be identified (Fig.

What is the initial imaging for small bowel obstruction?

CT Findings. Multidetector CT is the single best imaging tool for suspected SBO. Multidetector CT has a sensitivity and specificity of 95% for the diagnosis of high-grade SBO and is less accurate in partial obstruction (4,6–8).

What does a small bowel obstruction look like on a CT scan?

CT findings in a closed-loop obstruction depend on the length, the degree of distention, and the intra-abdominal orientation of the closed loop. Findings may include a U- or C-shaped loop of small bowel and a radial configuration of the mesentery, with stretched vessels converging on the site of a torsion.