1. Intestinal Obstruction 肠梗阻

3. Etiology and classification 1. According to its basic causes: mechanical obstruction dynamic obstruction obstruction of vascular supply origin

4. 2. According to whether the vascular supply to intestinal wall is compromised, Simple and strangulation obstruction .

5. 3. According to obstruction level or site . high and low obstruction 4. According to the extent of obstruction Incomplete and complete obstruction, 5. According to mode of onset and progression of obstruction. Acute and chronic obstruction

9. Clinical manifestations Abdominal pain Nausea and vomiting Obstipation Abdominal distention.

10. Physical Examination the signs of dehydration: Vital Signs:

21. Capsule endoscocpy : normal findings

22. Capsule endoscopy angiodysplasia, jejunum bleeding angiodysplasia, ileum

23. Diagnosis must make clear the following questions: 1. Whether intestinal obstruction exists: Through symptoms and signs, the diagnosis can be made without difficulty. Abdominal Radiology is much helpful in diagnosis.

24. 2. Whether the obstruction is mechanical or dynamic : mechanical obstruction, typical symptoms and signs. paralytic obstruction, cramping abdominal pain is absent, distention is prominent

25. 3. Whether the obstruction is simple or strangulation obstruction: Indications for strangulation: a. Developing continuous violently rather than intermittent pain b. Crisis rapidly and presence of toxemia (elevated temperature and leukocyte count), shock and rapid pulse c. Obvious peritoneal irritation d. A palpable tender abdominal mass with asymmetric distention

27. 4. Whether the obstruction is high or low: Vomiting, in proximal intestinal obstruction. Distention in low obstruction Abdominal radiography is helpful. 5. Whether the obstruction is complete or incomplete: frequency of vomiting, extent of distention, and radiography.

28. 6.Which causes leads to obstruction : According to the age, history, symptoms and signs, radiography. Postoperative adhesions, Postinflammatory origin Henias Congenital malformations Intestinal intussusception Obstruction of parasite origin Carcinomas and dry feces.

40. 1). Lysis of adhesion

41. reduction of torsion

42. 2)Enterectomy and 3)Bypass procedure for anastomosis. nonresectable lesions.

43. 4)Enterostomy

46. The Common Types Of Intestinal Obstruction

47. Peritoneal Adhesions and Bands----Adhesive Obstruction

51. 1. band compression 2. adhesion angulation

56. Placation for recurrent case

62. small bowel volvulus sigmoid colon volvulus

73. small intestine to small intestine ileocecal intussusception Ileum, cecum to colon colon to colon

76. barium enema Intussusception

90. Ascarids in small intestine

91. obstruction caused by ascarids

94. Other disese in small intestine

95. tumor in small intestine

96. trauma of small intestine

99. small intestine diverticulum

100. small intestine diverticulum and perforation

101. Aneurysm type B-cell lymphoma of the jejunum with remarkable wall thickening

102. A case of a metastatic jejunal tumor originating from pulmonary giant cell carcinoma in a patient whose chief complaint was melena.

103. Discussion

113. Whether the obstruction is mechanical or dynamic : the crampy abdominal pain and high-pitched bowel sounds

114. Whether the obstruction is simple or strangulation obstruction: Indications for strangulation: a. Developing continuous violently rather than intermittent pain b. Crisis rapidly and presence of toxemia (elevated temperature and leukocyte count), shock and rapid pulse c. Obvious peritoneal irritation d. A palpable tender abdominal mass with asymmetric distention

116. Whether the obstruction is complete or incomplete: complete

117. Postoperative adhesions, Postinflammatory origin Henias Congenital malformations Intestinal intussusception Obstruction of parasite origin Carcinomas and dry feces. Which causes leads to obstruction : His past medical history is remarkable in that he underwent an appendectomy for acute appendicitis eight months ago.

123. Conclusion

124. Diagnosis must make clear the following questions: 1. Whether intestinal obstruction exists 2. Whether the obstruction is mechanical or dynamic

125. 3. Whether the obstruction is simple or strangulation obstruction: Indications for strangulation: a. Developing continuous violently rather than intermittent pain b. Crisis rapidly and presence of toxemia (elevated temperature and leukocyte count), shock and rapid pulse c. Obvious peritoneal irritation d. A palpable tender abdominal mass with asymmetric distention

127. 4. Whether the obstruction is high or low 5. Whether the obstruction is complete or incomplete 6. Which causes leads to obstruction

131. The Common Types Of Intestinal Obstruction

132. Adhesive Obstruction