Warning signs of intestinal obstruction

According to Associate Professor, Dr. Nguyen Anh Tuan, Head of the Department of Digestive Surgery, Central Military Hospital 108, intestinal obstruction syndrome is a condition in which a patient’s intestines are functionally or mechanically obstructed. This prevents the normal movement of digestive products, causing them to accumulate and become clogged, preventing them from being eliminated from the patient’s body.

Intestinal obstruction has recognizable signs that patients need to pay attention to, as follows:

Physical symptoms

Three main physical symptoms:

Stomach-ache

Abdominal pain is always the initial symptom of the disease. The typical pain characteristic of intestinal obstruction is intermittent abdominal pain. The pain can begin slowly or suddenly and intensely, starting in the navel or flank area and quickly spreading throughout the abdomen. In intestinal obstruction due to obstruction, abdominal pain often becomes a typical attack, with no pain or mild pain outside of the attack.

In intestinal volvulus, intestinal pain begins suddenly and is intense like twisting, continuous pain without attacks, spreading to the back or lumbar area. The patient tried every position to relieve pain but to no avail.

Vomit

Appears at the same time as the pain but does not reduce the pain. At first, food is vomited, then bile is vomited, later the vomit may resemble stool. The nature of vomiting depends mainly on the location of obstruction, early and severe vomiting in high intestinal obstruction, late vomiting or only nausea in low intestinal obstruction.

Constipation, defecation

It may be present a few hours after the onset of the disease. The obstruction of defecation is often not obvious. In cases of high obstruction, it can be seen that there is still defecation due to the elimination of waste and feces under the obstruction. But even though I defecate, it doesn’t make the pain go away or reduce my stomach pain.

Whole body symptoms

The whole body condition depends first of all on the mechanism of intestinal obstruction, the location of the obstruction and the duration of the obstruction. If it comes early, signs of dehydration and electrolyte disorders are often unclear. If it comes later and the higher the blockage, the signs of dehydration will be more obvious with symptoms of thirst, sunken eyes, dry lips, wrinkled skin, little urine, and even signs of shock due to reduced circulatory volume.

In volvulus, shock may appear in the first hours of the illness due to intoxication.

Physical symptoms

Abdomen is distended and soft

The stomach was not distended from the beginning and was very variable. At first the bloating is only in the middle of the abdomen or on the ribs, then the bloating gradually increases. In high jejunal obstruction, close to the angle of Treitz, the abdomen is not distended or even flat. The abdomen is heavily distended in late intestinal obstruction, along the colonic framework in low colon-rectal obstruction. Uniform distention in intestinal obstruction due to obstruction, deviant distention in intestinal volvulus.

Signs of floating intestinal loops

You can see a bulging mass on the abdominal wall. When palpated, there is a feeling of tension, clear edges, and a strong sound to percussion. When you feel a loop of intestine that is very tense, painless, and immobile (Von Wahl’s sign), it is a very valuable sign to diagnose obstruction due to volvulus or intestinal strangulation.

Signs of snakes crawling

During the pain, the intestinal loops appear bulging and moving on the abdominal wall. This is the most characteristic sign of mechanical intestinal obstruction. But without these signs, intestinal obstruction cannot be ruled out.

Hearing a roaring sound due to the movement of gas and fluid in the intestinal lumen is also a sign that is as valuable as the snake crawling sign in diagnosing mechanical intestinal obstruction.

Abdominal examination sometimes shows abdominal wall reactions localized on twisted intestinal loops, resonant percussion in the middle of the abdomen due to bloating, and there may be signs of dullness to percussion in the lower area due to fluid in the abdomen.

In addition to the above signs, there are also a number of causes that can warn of intestinal obstruction such as colon tumors, small bowel tumors, intussusception masses, worms, hernias in the abdominal wall such as inguinal-femoral hernias, hernias in the abdominal wall. Obstructed navel, rectal cancer, late intussusception, sigmoid colon tumor prolapsing into the pelvis…