Bowel obstruction topics for General Physicians
How bowel obstruction is tested
Written for DHA, SMLE, DOH, QCHP, OMSB, MOH, NHRA and Kuwait MOH — the same GP licensing mix, not a bowel obstruction specialist paper.
Obstruction stems split small vs large bowel, adhesion vs hernia vs tumour, and the closed-loop emergency.
Adhesive SBO is a trial of non-operative care if there is no ischaemia. A tender irreducible hernia is not a drip-and-suck case.
Large-bowel obstruction thinks cancer and volvulus. Closed-loop and caecal diameter thresholds push theatre before perforation.
When is a drip-and-suck trial wrong?
Peritonism, fever, rising lactate, or an incarcerated hernia. Those patients are ischaemic until proven otherwise.
Sigmoid volvulus — first move if stable?
Endoscopic decompression then elective resection planning. Peritonism goes straight to theatre.
What X-ray finding do they still use?
Air-fluid levels and a transition point idea. CT is the modern confirmatory test in the stable patient.
More Surgery subspecialties