Consultant Corner: Bowel Obstruction
Bowel obstruction is a surgical disease and surgical consultation should occur early in management. The goals in treating bowel obstruction are to relieve intraluminal pressure by nasogastric decompression, resuscitate the patient, and intervene before ischemia, necrosis, and perforation occur. The complications of bowel obstruction are ischemia, perforation, sepsis, and death. Signs of bowel strangulation, ischemia, and perforation are all similar and include peritonitis, fever, tachycardia, leukocytosis, acidosis, and/or hemodynamic instability. Bariatric surgery patients, elderly and diabetic patients, and patients with obstruction due to malignancy require a higher degree of suspicion for complications and special considerations in management.
KeywordsBowel obstruction Nasogastric decompression Special populations Bowel ischemia Perforation
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