INTESTINAL OBSTRUCTION

Intestinal obstruction• It is an interruption in the flow of intestinal contents

through the intestine• In small or large intestine • Complete or partial

Causes • Congenital Intestinal obstruction

Intestinal atresia Malrotation of gut Meconium plug syndrome Meconium ileus Annular pancrease Mickel’s diverticulum Hirshsprung’s disease

Acquired intestinal obstruction

• Intussusception• Volvulus • Tumor or hematoma• Hernia and strangulation • Stricture or stenosis of intestine • Inflammatory disease• Foreign body • Worm mass• Paralytic ileus

Duodenal Atresia

• Duodenal atresia is the congenital absence or complete closure of a portion of the lumen of the duodenum

• 1 per 5000 to 10,000 live births• Affecting boys more commonly- than girls

Pathophysiology

Clinical manifestation • Abdominal distension

• Bilious vomiting

• Absence of flatus

• No passage of stool

• Respiratory distress

• Abdominal tenderness

• Shock

• Chance to have trisomy 21

Diagnostic evaluation • History collection • Physical examination • USG abdomen • X ray chest abdomen - double bubble • Blood test • CT scan

Management • IV fluids • Oro or nasogastric aspiration • Stomach wash • NPO• Antibiotics, Antiemetic ,vitamin

supplement, Antacids

Surgical management Laprotomy • Rescection bowel –strangulated bowel • Ladd’s band-malrotation • Enterotomy –foreign bodies • Stenosis-duodeno/ jejuno duodenostomy