Intestine: obstruction

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Sections available in full article Introduction, Presenting signs, Acute presentation, Age predisposition, Cost considerations, Pathogenesis, Etiology, Pathophysiology, Timecourse (incubation, duration), Diagnosis, Presenting problems, Client history, Clinical signs, Diagnostic investigation, Confirmation of diagnosis, Differential diagnosis, Treatment, Initial symptomatic treatment, Standard treatment, Monitoring, Sequelae, Prognosis, Sources, Publications, Vetstream contributor(s),
Contributors Dr Cheryl Hedlund DVM MS
Prof Ed Hall MA VetMB PhD DipECVIM MRCVS
Synonyms Intestinal blockage Intestinal foreign bodies

Introduction

  • Bowel obstruction is a frequent occurrence and is the most common indication for surgical intervention involving the gastrointestinal tract.
  • Classified as simple (mechanical or functional), or strangulated  Intestine: strangulated obstruction hernia  .
  • Simple obstructions can be high (proximal), and involve the pylorus, duodenum and the proximal jejunum. A low (distal), small bowel obstruction involves the lower one-half of the jejunum and ileum.
  • Cause :
    • Foreign bodies  Intestine: foreign body - linear  .
    • Tumors (lymphosarcoma  Lymphoma  , annular adenocarcinoma).
    • Strictures due to trauma or prior surgery.
    • Intussusception  Intussusception  .
    • Abscesses or adhesions (rarely).
  • Signs : variable but may include dehydration, hypovolemic shock  Shock  , endotoxic shock  Shock: septic  , and death.
  • Diagnosis : radiography.
  • Treatment : usually surgical intervention.
  • Prognosis : higher mortality rates are associated with strangulation and high obstructions.

Diagnosis

Clinical signs

  • Dehydration.
  • Hypovolemic shock.
  • Endotoxic shock.
  • Abdominal pain.
  • Abdominal mass.

Diagnosis

Differential diagnosis

  • Other causes of acute vomiting:
    • Infectious, eg panleukopenia  Feline panleucopenia virus disease  .
    • Gastritis  Chronic gastritis  - traumatic, irritant, allergic.
    • Uremia  Uremia  .
    • Poisoning.
  • Obstruction due to other cause:
    • Neoplasia  Small intestine: neoplasia  ,  Large intestine: neoplasia  .
    • Intussusception  Intussusception  .

Sequelae

Prognosis

  • Excellent in acute cases with rapid surgical correction.
  • Guarded if chronic obstruction, particularly if intestine perforated.
  • Cessation of vomiting.
  • Breakdown of surgical repair.
  • Pre-existing peritonitis.
  • Bacteria breach intestine wall   →   endotoxic shock.

Sources

Publications

Refereed papers

  • Barrs V Ret al(1999)Intestinal obstruction by trichobezoars in five cats.J Fel Med Surg1(4), 199-207.

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