Definition Intestinal Obstruction: Blockage preventing the normal flow of intestinal contents through the digestive tract. Ileus: A type of bowel obstruction caused by a lack of peristalsis or motility, without any physical blockage. Types & Causes Mechanical Obstruction: Physical barrier such as tumours, hernias, or strictures. Functional Obstruction (Ileus): Resulting from neuromuscular dysfunction, e.g., post-operative ileus, medications, or spinal injuries. Clinical Presentation Colicky abdominal pain. Vomiting: faeculent in lower obstruction. Constipation and absence of flatus. Distended abdomen. Audible bowel sounds, or “tinkling” in mechanical; absent in ileus. Complications Strangulation leading to bowel ischaemia. Dehydration and electrolyte imbalances. Peritonitis if bowel perforates. Bowel necrosis. Investigations Plain abdominal X-ray: dilated bowel loops, air-fluid levels in obstruction. CT scan: Detailed view, especially in suspected strangulation. Abdominal ultrasound: Particularly in suspected intussusception in children. Blood tests: Electrolytes, kidney function, lactate (if strangulation suspected). Management Nil by mouth (NBM) and nasogastric tube insertion for decompression. Fluid resuscitation and correction of electrolyte imbalances. Surgery: In cases of mechanical obstruction, especially if strangulation or necrosis is suspected. For ileus, treat the underlying cause, e.g., discontinuing causative medications. Differential Diagnoses Gastroenteritis, pancreatitis, mesenteric ischaemia, and more.
