Intestinal obstruction
Key points
- Intestinal obstruction involves a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through.
- Obstruction of the bowel may be caused by ileus - in which the bowel doesn't function correctly but there is no "mechanical" (anatomic) problem - or by mechanical causes.
- While listening to the abdomen with a stethoscope your health care provider may hear high-pitched bowel sounds at the onset of mechanical obstruction.
- Calling your health care provider Call your health care provider if persistent abdominal distention develops and you are unable to pass stool or gas, or if other symptoms of intestinal obstruction develop.
Alternative names
Paralytic ileus; Intestinal volvulus; Bowel obstruction; Ileus; Pseudo-obstruction - intestinal
Definition
Intestinal obstruction involves a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through.
Causes, incidence, and risk factors
Obstruction of the bowel may be caused by ileus - in which the bowel doesn't function correctly but there is no "mechanical" (anatomic) problem - or by mechanical causes. Paralytic ileus, also called pseudo-obstruction, is one of the major causes of obstruction in infants and children.
The causes of paralytic ileus may include the following:
- Medications, especially narcotics
- Intraperitoneal infection
- Mesenteric ischemia (decreased blood supply to the support structures in the abdomen)
- Injury to the abdominal blood supply
- Complications of intra-abdominal surgery
- Kidney or thoracic disease
- Metabolic disturbances (such as decreased potassium levels)
Paralytic ileus may lead to complications causing jaundice and electrolyte imbalances. In the newborn, paralytic ileus that is associated with destruction of the bowel wall (necrotizing enterocolitis) is life-threatening and may lead to infection in the infant's blood and lungs.
In older children, gastroenteritis may be a cause of paralytic ileus, which is sometimes associated with peritonitis and a ruptured appendix.
Paralytic ileus is marked by abdominal distention, absent bowel sounds (no noise heard when listening to abdomen) and relatively little pain (as compared to mechanical obstruction).
Mechanical obstruction occurs when movement of material through the intestines is physically blocked. The mechanical causes of obstruction are numerous and may include the following:
- Hernias
- Postoperative adhesions or scar tissue
- Impacted feces (stool)
- Gallstones
- Tumors blocking the intestines
- Granulomatous processes (abnormal tissue growth)
- Intussusception
- Volvulus (twisted intestine)
- Foreign bodies (ingested materials that obstruct the intestines)
If the obstruction blocks the blood supply to the intestine, the tissue may die, causing infection and gangrene. Risk factors for tissue death include intestinal malignancy, Crohn's disease, hernia, and previous abdominal surgery.
Frequently asked questions
What is intestinal obstruction?
Intestinal obstruction involves a partial or complete blockage of the bowel that results in the failure of the intestinal contents to pass through.
What are the risk factors for intestinal obstruction?
Obstruction of the bowel may be caused by ileus - in which the bowel doesn't function correctly but there is no "mechanical" (anatomic) problem - or by mechanical causes. Paralytic ileus, also called pseudo-obstruction, is one of the major causes of obstruction in infants and children.
What are the symptoms of intestinal obstruction?
- Abdominal fullness, gaseous
- Abdominal distention
- Abdominal pain and cramping
- Vomiting
- Failure to pass gas or stool (constipation)
- Diarrhea
- Breath odor
What are the complications of intestinal obstruction?
- Infection
- Gangrene of the bowel
- Perforation (hole) in the intestine Calling your health care provider Call your health care provider if persistent abdominal distention develops and you are unable to pass stool or gas, or if other symptoms of intestinal obstruction develop.
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
health.am provides general information, not medical advice. Always consult a qualified health professional about your own health.