Correcting Physiologic Derangements to Prevent Intestinal Obstruction

A dilated bowel contains a large amount of fluid, foodstuff, or gas. Bowel or intestinal obstruction is the dilatation of intestinal segments close to the site of obstruction or collapse of the segment distal to the obstruction.

Bowel obstruction can be due to obturation by blockage of the lumen by bowel content, such as food stuff, bezoar, or gallstone, due to bowel wall abnormality, such as neoplasm or stenosis, and due to extrinsic causes, such as adhesion and hernia.

Diagnostic Testing and Imaging: Laboratory evaluation of patients with suspected obstruction should include a complete blood count and metabolic panel.

Radiography: Initial evaluation of people with clinical signs and symptoms of intestinal obstruction should include plain upright abdominal radiography

Computed Tomography: It is recommended for further evaluation of the suspected cases in whom radiorgraphy and clinical examination do not produce a definitive diagnosis.

Magnetic resonance imaging: MRI is considered to be more sensitive and precise than CT in diagnosing intestinal obstruction. MRI enteroclysis, involving intubation of the duodenum along with infusion of contrast material straight into the small intestine, can more reliably determine the location and cause of the obstruction. Contrast fluoroscopy, such as a small bowel follow-through, is helpful in the evaluation of a partial intestinal obstruction.

Management and treatment of intestinal obstruction in Kolkata is geared towards correcting physiologic derangements that result from the obstruction, bowel rest, and consequently removing the source of obstruction.

The intestinal obstruction surgeon in Kolkata would look for peritonitis, clinical instability, or unexplained leukocytosis or acidosis, intestinal ischemia, or perforation; these findings mandate immediate surgical exploration.