| Bowel obstruction | |
|---|---|
| Other names | Intestinal obstruction, intestinal occlusion |
 | |
| Upright abdominal X-ray demonstrating a small bowel obstruction. Note multiple air fluid levels. | |
| Specialty | General surgery |
| Symptoms | Abdominal pain, vomiting, bloating, not passing gas[1] |
| Complications | Sepsis, bowel ischemia, bowel perforation[1] |
| Causes | Adhesions, hernias, volvulus, endometriosis, inflammatory bowel disease, appendicitis, tumors, diverticulitis, ischemic bowel, tuberculosis, intussusception[2][1] |
| Diagnostic method | Medical imaging[1] |
| Treatment | Conservative care, surgery[2] |
| Frequency | 3.2 million (2015)[3] |
| Deaths | 238,733 (2019)[4] |
Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion.[2][5] Either the small bowel or large bowel may be affected.[1] Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas.[1] Mechanical obstruction is the cause of about 5 to 15% of cases of severe abdominal pain of sudden onset requiring admission to hospital.[1][2]
Causes of bowel obstruction include adhesions, hernias, volvulus, endometriosis, inflammatory bowel disease, appendicitis, tumors, diverticulitis, ischemic bowel, tuberculosis and intussusception.[1][2] Small bowel obstructions are most often due to adhesions and hernias while large bowel obstructions are most often due to tumors and volvulus.[1][2] The diagnosis may be made on plain X-rays; however, CT scan is more accurate.[1] Ultrasound or MRI may help in the diagnosis of children or pregnant women.[1]
The condition may be treated conservatively or with surgery.[2] Typically intravenous fluids are given, a nasogastric (NG) tube is placed through the nose into the stomach to decompress the intestines, and pain medications are given.[2] Antibiotics are often given.[2] In small bowel obstruction about 25% require surgery.[6] Complications may include sepsis, bowel ischemia and bowel perforation.[1]
About 3.2 million cases of bowel obstruction occurred in 2015 which resulted in 264,000 deaths.[3][7] Both sexes are equally affected and the condition can occur at any age.[6] Bowel obstruction has been documented throughout history, with cases detailed in the Ebers Papyrus of 1550 BC and by Hippocrates.[8]
- ^ a b c d e f g h i j k l Gore RM, Silvers RI, Thakrar KH, Wenzke DR, Mehta UK, Newmark GM, et al. (November 2015). "Bowel Obstruction". Radiologic Clinics of North America. 53 (6): 1225–40. doi:10.1016/j.rcl.2015.06.008. PMID 26526435.
- ^ a b c d e f g h i Fitzgerald JE (2010). "Small Bowel Obstruction". Emergency Surgery. Oxford: Wiley-Blackwell. pp. 74–79. doi:10.1002/9781444315172.ch14. ISBN 978-1-4051-7025-3. Archived from the original on September 8, 2017.
- ^ a b Vos T, Allen C, Arora M, Barber RM, Bhutta ZA, Brown A, et al. (October 2016). "Global, regional, and national incidence, prevalence, and years lived with disability for 310 diseases and injuries, 1990-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1545–1602. doi:10.1016/S0140-6736(16)31678-6. PMC 5055577. PMID 27733282.
- ^ Long D, Mao C, Liu Y, Zhou T, Xu Y, Zhu Y (October 3, 2023). "Global, regional, and national burden of intestinal obstruction from 1990 to 2019: an analysis from the Global Burden of Disease Study 2019". International Journal of Colorectal Disease. 38 (1): 245. doi:10.1007/s00384-023-04522-6. ISSN 1432-1262. PMID 37787806.
- ^ Adams JG (2012). Emergency Medicine: Clinical Essentials (Expert Consult -- Online). Elsevier Health Sciences. p. 331. ISBN 978-1-4557-3394-1. Archived from the original on September 8, 2017.
- ^ a b Ferri FF (2014). Ferri's Clinical Advisor 2015: 5 Books in 1. Elsevier Health Sciences. p. 1093. ISBN 978-0-323-08430-7. Archived from the original on September 8, 2017.
- ^ Wang H, Naghavi M, Allen C, Barber RM, Bhutta ZA, Carter A, et al. (October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
- ^ Yeo CJ, McFadden DW, Pemberton JH, Peters JH, Matthews JB (2012). Shackelford's Surgery of the Alimentary Tract. Elsevier Health Sciences. p. 1851. ISBN 978-1-4557-3807-6. Archived from the original on September 8, 2017.