Surgery

intestinal obstruction

Q: What is the gold standard imaging modality for diagnosing intestinal obstruction?

CT Abdomen is identified as the Gold Standard for diagnosing intestinal obstruction. It provides detailed findings including the transition point, level and cause of obstruction, and signs of complications like strangulation.

Q: Which of the following is an intraluminal cause of small bowel obstruction?

Gallstone ileus is listed as an intraluminal cause of SBO, occurring within the lumen. Adhesions are extraluminal, Crohn's disease is intramural, and volvulus is also extraluminal.

Q: What is the normal maximum diameter of the small bowel before it is considered dilated?

According to the image, normal diameters are: small bowel ≤3 cm, colon ≤6 cm, and cecum ≤9 cm. Diameters exceeding these values indicate dilation.

Q: Which radiographic sign on X-ray indicates sigmoid volvulus?

The coffee-bean sign on plain abdominal X-ray is characteristic of sigmoid volvulus. The string of beads sign indicates gas trapped between valvulae, and cut-off sign indicates the site of block.

Q: What is the first step in management of all types of intestinal obstruction?

Initial resuscitation is always first in management of intestinal obstruction. This includes NPO, IV fluids to correct dehydration and electrolytes, NG tube for decompression, and urinary catheter.

Intestinal obstruction refers to the mechanical or functional blockage of intestinal contents passage through the bowel, which can occur at the small bowel or large bowel level due to causes within the lumen, within the bowel wall, or from external compression. This condition is clinically significant because it can rapidly progress from simple obstruction to strangulation, leading to bowel ischemia, necrosis, perforation, and life-threatening sepsis, making early recognition and appropriate management critical. Medical students must understand the distinguishing features between small and large bowel obstruction, recognize the warning signs of strangulation such as pain out of proportion to findings with fever and metabolic acidosis, and appreciate that while simple adhesive small bowel obstruction may be managed conservatively, strangulated or closed-loop obstructions require emergency surgical intervention.

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1. What is the gold standard imaging modality for diagnosing intestinal obstruction?

2. Which of the following is an intraluminal cause of small bowel obstruction?

3. What is the normal maximum diameter of the small bowel before it is considered dilated?

4. Which radiographic sign on X-ray indicates sigmoid volvulus?

5. What is the first step in management of all types of intestinal obstruction?

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intestinal obstruction

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