Intestinal Obstruction

Intestinal Obstruction

Joseph Tjan

A. Medical Disease and Differential Diagnosis

  • What is the differential diagnosis of the acute abdomen?

  • What are the causes of intestinal obstruction of the small bowel and of the large bowel?

  • Differentiate between simple and strangulated bowel obstruction.

  • Is it important to differentiate whether the bowel obstruction is located in the small bowel or large bowel? Why?

  • What are the signs and symptoms of intestinal obstruction?

  • What are the causes and effects of bowel distention?

  • Describe the fluid shifts during small bowel intestinal obstruction.

  • Discuss the systemic derangements that occur with intestinal obstruction.

  • Can there be actual losses of red cell mass?

  • What is an ileus? Discuss its causes and treatment.

  • What are the systemic effects from the absorption of bacteria and bacterial products?

B. Preoperative Evaluation and Preparation

  • Is it important to decompress the abdomen before surgical intervention? Why?

  • Describe the respiratory implications.

  • What are the implications of the tense abdominal wall?

  • Outline the methods of abdominal decompression.

  • Discuss the goals of fluid management.

  • What would you use as a guide to fluid volume replacement?

C. Intraoperative Management

  • What dangers are present during induction? How are they planned for?

  • Does the administration of antacids and/or histamine-2 (H2) blockers before the induction of anesthesia have a significant value in patients with small bowel obstruction?

  • In what position would you intubate this patient?

  • Is succinylcholine the best muscle relaxant to use for the rapid sequence induction?

  • Would you remove or leave the nasogastric tube (NGT) in place before inducing anesthesia?

  • Would you use nitrous oxide in this patient?

  • Are there any benefits to using a high concentration of inspired oxygen?

D. Postoperative Management

Mar 18, 2021 | Posted by in ANESTHESIA | Comments Off on Intestinal Obstruction

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