Bowel Obstruction

Bowel obstruction stops intestinal contents, gas, and secretions from moving normally. A mechanical obstruction physically narrows or blocks the lumen, as with adhesions, a hernia, tumour, volvulus, or another lesion. A functional obstruction, often called ileus, occurs when propulsion fails because of neuromuscular dysfunction, systemic illness, medications, or ischemia rather than a fixed blockage. Either type may be partial or complete and may develop acutely or chronically. The clinical danger is not distention alone. Gas and fluid accumulate above the obstruction, vomiting and third-spacing reduce circulating volume, and rising intraluminal pressure can impair bowel-wall perfusion. A closed-loop obstruction can lose its blood supply rapidly. Assessment therefore asks two questions at once: does the pattern suggest obstruction, and is the patient developing hypovolemia, ischemia, perforation, or shock?