First aid for intestinal obstruction

Intestinal obstruction is a pathological condition in the development of which the natural movement of intestinal contents is disturbed.

There are many reasons for impassability. Most often in practice, it is mechanical obstruction that occurs – that is, based on the occurrence of various obstacles. Mechanical obstruction is of two types – obstructive and strangulation. In the first case, the cause of the development of the pathology may be the growth of a tumor inside the intestine, in the second case, we are talking about torsion or infringement of the intestines. In addition to the mechanical appearance, there is also a dynamic obstruction caused by impaired intestinal motility. There are several reasons for this phenomenon – spasm of blood vessels and nerves, reflex disorders, and more.

Symptoms

The first signs of the disease are abdominal pain, characterized by instability. That is, a person experiences sharp pain attacks, after which relief comes. When the intestinal walls are infringed, the pain is constant, at times intensifying.

Due to the accumulation of gases, the abdomen swells (the increase is asymmetric). At the same time, the enlarged intestine closely adheres to the walls of the abdominal cavity, which makes its contractions visually noticeable. A little later, vomiting develops, the smell and contents of the vomit gradually change. In advanced cases, it is possible to intersperse feces in the vomit. The chair and gases are absent. Bloating may be accompanied by intestinal noises, which disappear over time, but a sound appears that is vaguely reminiscent of splashes of water.

The danger of obstruction lies in the fact that at the initial stage of the disease it is almost impossible to identify its signs during a standard examination. Palpation does not bring severe discomfort, the temperature does not rise. A sharp deterioration occurs at the moment when the death of intestinal tissues begins. Symptoms of peritonitis are manifested – acute pain in the abdomen, dry mouth, the appearance of brown plaque in the oral cavity, fever, chills, rapid weak pulse. A blood test can show a sharp jump in the level of white blood cells.

There are three stages of the development of the disease – early (up to 12 hours), intermediate (12-24 hours) and late (more than 24 hours). If the patient is taken to the hospital at the last stage of intestinal obstruction, he has already developed intoxication of the body, pus accumulates in the abdominal cavity, which can cause sepsis – a critical condition, it will be quite difficult to save a life.

Diagnostics

Diagnosis of intestinal obstruction is a comprehensive examination of the patient, which includes the following procedures:

• examination – palpation of the abdomen, determination of the color of the skin, control of body temperature and blood pressure;
• X-ray of the large intestine – if there is a suspicion of an intermediate or late stage, the study is carried out immediately;
• blood test – general and biochemical;
• Ultrasound or CT of the abdominal cavity are methods that allow you to visualize the possible cause of obstruction.

In some cases, there are indications for laparoscopy. Most often, this measure is resorted to when external signs confirm the diagnosis, and the critical condition of the patient does not allow for a complete diagnosis. With laparoscopy, the doctor not only identifies the pathological part of the intestine, but can also directly begin treatment.

If the patient is delivered at an early stage of the development of the disease and the listed methods do not make it possible to establish a diagnosis, a contrast radiography of the passage of barium through the intestine is shown with a review every two hours. Until the full clarification of the circumstances, the patient remains in the hospital.

First aid for intestinal obstruction

Intestinal obstruction is a condition that requires surgical intervention. Medical therapy is completely ineffective. Therefore, if you suspect such a condition, you should immediately seek medical help.

Before the arrival of the ambulance team, the patient must be laid on a flat horizontal surface, providing him with complete rest as much as possible.

It is strictly forbidden to induce stools with the use of laxatives – the desired effect will not be achieved, and by increasing the frequency of contraction of the intestinal walls, the patient’s condition will worsen.

You can give a cool drink in small doses. It is important to monitor body temperature, blood pressure, pulse. This information will facilitate and speed up the diagnosis by specialists.

If the patient is in a serious condition, the paramedic can provide initial therapy, which includes injections of drugs to relieve spasm and infusions with a plasma replacement solution. With severe and painful vomiting, a special probe is installed to facilitate the withdrawal of vomit.

Intestinal obstruction treatment

Mechanical obstruction is eliminated exclusively by surgery. The type of operation depends on the causes of the pathology. For example, if the cause of blockage of the intestine is the ingress of a foreign body into it and the formation of a large fecal stone, a surgical opening of the intestine is indicated. Volvulus can be corrected by untwisting the loop. To avoid recurrence of the disease, the problem area is fixed or shortened. If there is a death of intestinal tissues, atrophied areas are excised, followed by stitching of the intestine.

Dynamic obstruction allows the use of conservative therapy. In this case, the patient must be under continuous medical supervision, since the risk of developing sepsis remains high.

Patients with suspected acute intestinal obstruction are immediately taken to the surgical department. The complex of diagnostic measures depends on the patient’s indicators – if the condition is critical, an urgent operation is performed, during which the diagnosis is first confirmed, and then the cause of the pathology is eliminated.

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