Large bowel obstruction

Question 1

Causes

Answer 1

Colorectal cancer
Benign stricture
Volvulus
Hernias

Question 2

Clinical features

Answer 2

Gradual development
Abdominal distension (cramping) 
Absolute constipation 
Abdominal pain - colicky, intermittent 
Vomiting 
Tinkling bowel sounds 
Palpable mass possibly ?

Question 3

Investigations

Answer 3

AXR supine

CT scan

Question 4

Management

Answer 4

IV fluids
Operate
Stent
Nil by mouth

Question 5

Sigmoid volvulus - cause

Answer 5

Bowel twists on mesentery

This blocks lumen and blood supply

Question 6

Sigmoid volvulus - investigations (and findings)

Answer 6

AXR - coffee bean shape

Question 7

Sigmoid volvulus - management

Answer 7

Surgical resection
Stent
Flatus tube

Question 8

Sigmoid volvulus - who gets it

Answer 8

Elderly patients

Question 9

Pseudo-obstruction - what is it

Answer 9

No real obstruction

Mimics large bowel obstruction

Question 10

Pseudo-obstruction - who gets it

Answer 10

Elderly

Debilitated