What is bowel obstruction?
Bowel obstruction describes a condition in which the normal flow of gastrointestinal content is either completely or partiality blocked. This could be caused by medical conditions or medications, otherwise known as an ilius. A common example of this is seen in patients that are taking pain medications or narcotics. Another common condition is post surgical scar tissue, or adhesions.
These will cause a point around which a twist of the bowel will cause a compromise of the blood flow to it and eventually result in “dead bowel”. Just
imagine what would happen if you were to place a tight rubber band around a finger? In a very short period of time, the blood supply to the finger is
compromised and if it is not quickly restored then it will result in the loss of a finger.
One of the problems with the diagnosis of bowel obstruction is that there is no absolute set of studies, such as X-ray, Cat-Scan, laboratory studies
that will be diagnostic in all cases. This is even more so in patients that have had weight-loss surgical procedures. The anatomy is modified after all weight-loss surgical procedures. This varied anatomy means that there are instances that the expected findings of bowel obstruction are not present, or there are findings that are highly suspicious for bowel obstruction if the treating physician is acutely aware of the altered anatomy.
The treatment options are also different when treating a patient with bowel obstruction if they have had weight loss surgery. There are non surgical treatments that may be attempted for partial bowel obstruction (such as the nasogastric tube) that will be useless in post gastric bypass or duodenal switch patients. This is because in the duodenal switch and the gastric bypass operation, the anatomy is altered so that a partial segment of the gastrointestinal track has only limited access to outside. This means that the only way to decompress that segment is by surgery and not the naso-gastric tube.
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