肠梗阻PPT课件

Recurrent vomiting of bile-stained fluid Prolonged nausea precedes vomiting, feculent. Vomiting is a late finding if the ileocecal valve prevents
Etiology and classification
1.According to its basic causes: mechanical, dynamic
obstruction,and obsturction of vascular supply origin
1). Mechanical obstruction
Simple obstruction, without threat to the viability of the intestinal wall. Strangulation obstruction, the vascular supply is compromised.
3.According to obstruction level or site.
Clinical manifestations Nausea and vomiting Colicky abdominal pain Obstipation Abdominal distention. Their onset varies not only with the duration of established obstruction but also with its anatomic site.
from lesions within the wall of the intestine, intrinsic from extra-intestinal lesions , extrinsic from obstructing intra-luminal substances. congenital, inflammatory, neoplastic, or traumatic origin. Adhesions of postoperative, congenital origin, Henias Intra-luminaal foreign bodies
results in severe peritonitis and toxemia.
Shock Severe dehydration, decrease of blood volume electrolytic disturbance, acid-base imbalance, bacterial infection and toxemia,
Absorption and secretion
water and electrolytes accumulate. a decrease in absorption,
an increase in intestinal secretion.
Infection and toxemia
The bacteria proliferate, produce toxin. Vascular supply or viability compromised,
Proximal, distal intestinal, or large bowel obstruction, or high and low obstruction
4.According to the extent of obstruction
Incomplete and complausea and vomiting:
may be the only symptoms.
1).The nature of the vomitus.
undigested food particles. becomes bilious. feculent.
2).The onset and character of vomiting.
3). Obstruction of blood supply origin
thrombosis or embolism, then intestinal paralysis.
2.According to whether the vascular supply to intestinal wall is compromised, Simple and strangulation obstruction.
Intestinal obstruction
Defination
A blockade of the flow of intestinal content. Anatomic, functional changes but also systemically physiologic disorders.
2). Dynamic obstruction
Nerval reflex or toxin stimulation, acute diffuse peritonitis, abdominal operation, retroperitoneal hematoma and infection. Spastic obstruction in intestinal functional disorder or toxication.
5.According to mode of onset and progression of obstruction.
Acute and chronic obstruction
Pathophysiology
Motility of the small intestine The intestine contracts vigorously, The patient complains bitterly of crampy abdominal pain, Finally the intestine dilated.