Bowel Obstruction

Bowel obstruction is a partial or complete interruption of intestinal flow. A mechanical obstruction blocks the lumen; ileus and acute colonic pseudo-obstruction impair propulsion without the same physical blockage and are important look-alikes. The clinical pattern is colicky abdominal pain, vomiting, distension, and reduced or absent passage of stool and flatus. The RN priority is to determine whether the bowel is simply distended or whether perfusion is failing. A patient can deteriorate from fluid loss and third spacing to shock, bowel necrosis, sepsis, and perforation, so a change from intermittent cramping to constant pain changes the urgency.