15:07,30,Mar,2010 | (1509/0/0) | Original

small bowel intestinal obstruction


Mechanical obstruction of the proximal small bowel obstruction caused by intestinal gas fluid volume, resulting in expansion of the small intestine, the liquid intake, digestion and intestinal secretion caused by intestinal gas expansion. The same as mentioned earlier, a lot of saliva, gastric juice, bile and pancreatic juice into the small intestine each day. Only a very small stomach, meaning the ability to absorb liquid, therefore, most of the digestive juice is absorbed through the small intestine.
Peristalsis of small intestine under normal conditions to promote export of gas to the far side of the movement, through the rectum to fart in the form of discharge. Proximal small bowel obstruction in the accumulation of gas from swallowed air, and bicarbonate in the produced carbon dioxide and produced by bacterial fermentation of organic gases. In intestinal obstruction, swallowing the air is the most important source of gas, because the nitrogen concentration in the air is very high, and intestinal mucosa can not absorb nitrogen.
Result, the small intestine of the gas is mainly nitrogen (70%) in the intestine of large quantities of carbon dioxide is absorbed easily, so the bloating is minimal.
Small bowel obstruction in simple mechanical process, one of the most important thing is the body of water and electrolyte loss, mainly caused by the expansion of the small intestine. First of all, the vomiting reflex can be caused by the expansion of the small intestine. In addition, small intestinal obstruction, intestinal expansion of self-increase, as inflation increases intestinal secretion. Experiments on dogs show: bowel obstruction caused by intestinal absorption of expansion began to reduce (the intestine to reduce the water flow of blood), but the absorption of distal small bowel obstruction functioning. This phenomenon is the obstruction of the proximal intestinal fluid accumulation increased. Dehydration may further increase, causing further bowel expansion. Proximal to the obstruction of the development. In the human body, obstruction of the small intestine secretion is increased.
Simple mechanical intestinal obstruction in the small intestine, the liquid is lost depends on the obstruction of metabolism and duration of the site. More distal small bowel obstruction proximal to obstruction of the bowel and vomiting re-expansion of light. Proximal obstruction caused by water, sodium, chloride, hydrogen ion and potassium ion loss, resulting in dehydration and low chlorine associated with hypertriglyceridemia, hypokalemia and metabolic alkalosis. Distal small bowel obstruction to fluid accumulation in the large intestine; However, plasma electrolyte abnormalities are usually not heavy. May be due to the loss of hydrochloric acid less of it.
Dehydration can be combined oliguria, azotemia and blood concentration. If dehydration persists, tachycardia, central venous pressure and cardiac output is reduced low-cycle changes such as b
lood pressure and can cause hemorrhagic shock, small bowel dilatation after the onset of the other, including intra-abdominal pressure, increased blood volume reduction of the lower extremities Huixin and diaphragm increased enough to cause ventilation of these obstacles.
Intestinal obstruction can cause the rapid proliferation of bacteria. Under normal circumstances, a very small amount of bacteria in the small intestine, and almost sterile. Small number of bacteria in the small intestine due to a combination, and normal motility and digestion of migrating myoelectric complex spread between the luminal contents of the continuously moving, etc. can be put to the distal intestinal flora to a minimum. When the small bowel stasis, whether caused by reason, the bacteria within the intestine are rapidly proliferating, particularly in intestinal obstruction. Since a large number of bacteria present, so the contents into the small intestine-like stool. Under normal circumstances, as storage organs - colon contains a lot of bacteria.
Although recent studies have shown that: are able to survive the expansion of the small intestine bacterial translocation can occur, but the intestinal bacteria may be simple mechanical role in the pathology of small bowel obstruction are small.
small bowel intestinal obstruction

Home> academic journals> Diagnostics THEORY AND PRACTICE "2007 3> enteroscopy diagnosis of incomplete small-bowel obstruction
Diagnosis of double balloon enteroscopy incomplete intestinal obstruction Value of double-balloon enteroscopy in diagnosing partial small bowel obstruction
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Objective: To evaluate the double-balloon enteroscopy (DBE) in the diagnosis of incomplete small bowel obstruction in the role. Methods: from December 2004 to January 2006, our hospital clinical and imaging diagnosis of incomplete small bowel obstruction in patients 45 cases, postoperative adhesions than highly suspected small bowel obstruction caused by the incomplete, the rest of the patients in stable condition DBE examination, collection and analysis of clinical observation data. Results: 29 patients were 30 DBE examinations were 27 cases (93.1%) were clear obstruction causes DBE examination, 17 patients (58.6%) received pathological diagnosis. that could explain the cause of intestinal obstruction in incomplete intestinal tumors accounted for 48.3%; Crohn's disease caused by intestinal stenosis accounted for 24.1%. DBE diagnosis of small bowel obstruction cause of incomplete sensitivity of 96.4%, specificity of 100%, positive predictive value of 100%, negative predictive value of 50% .26 patients (89.7%) patients with an average follow-up 9.4 months (4 to 18 months), of which 21 cases (72.4%) small bowel obstruction did not occur again. Conclusion: DBE examination of non-surgical adhesions caused by incomplete small bowel obstruction with a high diagnostic value, is a safe and feasible screening method. of: Bo Sun Chengshi Dan Zhang Shu Zhang Chenli Gu Wei Zhong Jie Shen Philosophia SUN BoCHENG Shi-danGU WeiSHEN Rui-zheZHANG ShuZHANG Cheng-liZHONG Jie Author: Shanghai Jiao Tong University School of Medicine Department of Gastroenterology, Ruijin Hospital, Shanghai 200025 Title: Diagnosis Theory and Practice of ISTIC English title: JOURNAL OF DIAGNOSTICS CONCEPTS
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