Bowel Obstruction

An obstructed bowel cannot move intestinal contents forward. Fluid, gas, and secretions collect above the blockage, producing distension, vomiting, dehydration, and electrolyte loss. As pressure rises, venous drainage and then arterial perfusion can fail; ischemia may progress to necrosis, perforation, sepsis, and shock. The bedside pattern is usually colicky abdominal pain, vomiting, progressive distension, and reduced passage of stool or flatus. Do not let a small bowel movement falsely reassure you: partial obstruction can still be present. The immediate clinical question is whether the bowel is becoming strangulated or perforated, because those findings change management from observation and decompression to urgent surgery.