LBO

1. LARGE BOWEL
OBSTRUCTION

2. DEFINATION
 LARGE BOWEL OBSTRUCTION (LBO)
Large-bowel obstruction is an emergency
condition that requires early identification and
intervention. The etiology of this condition is age
dependent, and it can result from either mechanical
interruption of the flow of intestinal contents or by
the dilation of the colon in the absence of an
anatomic lesion (pseudo-obstruction)

3. CAUSES/RISK FACTORS
Common causes: cancer
Other causes: volvulus, diverticular
disease, inflammatory disorders.
E.g: crohn’s disease and fecal
impaction.

4. SIGN AND SYMPTOM
 1.Vomiting
 2.bloating
 3.constipation and lack of gas(if intestine is
completely blocked)
 4.diarrhea(if the intestine is partly blocked)
 5.cramping and belly pain that comes and goes.The
pain can occur around or below the belly button.

5. SMALL BOWEL LARGE BOWEL
OBSTRUCTION OBSTRUCTION

6. The colon proximal to the cause of mechanical obstruction (e.g.,
malignancy, colonic volvulus, benign ) dilates and, with increased
colonic pressure
mesenteric blood flow is reduced producing mucosal oedema with
transudation of fluid and electrolytes into the colonic lumen
This can produce dehydration and electrolyte imbalances. With
progression, the arterial blood supply becomes disturbed with mucosal
ulceration
This results in ischaemia, necrosis, and perforation.

7. INVESTIGATIONS
1 ) Flat and upright Abdominal x-ray
show distended bowel
2) CT Scan
to assess the cause of the obstruction
3) Gastrografin
to provide contrast than barium when bowel obstruction is
suspected
4 ) Barium enema
to confirm diagnosis of large bowel obstruction
5 ) Blood investigation
evaluate presence of infection & fluid and electrolyte imbalance
WBC - high due to inflammatory response

8. BLOOD INVESTIGATION
1 ) serum osmolality & electrolyte levels
2 ) in hypovolemia
3 ) arterial blood gases (ABG)

9. TREATMENT
1. Insertion of nasogastric tube through your
nose and down into your stomach. The tube
removes fluids and gas and helps relieve pain
and pressure. You will not be given anything
to eat or drink.

10. SURGICAL TREATMENT
 Exploration– make incision (cut) and
inspect what is the cause and remove the
infarcted part or gangreous tissue.
 Laparotomy- surgical opening of the
abdomen.

12. SURGICAL TREATMENT (CON’T)
 Ifobstruction was caused by adhesion –
removed or lysed.
 If tumours are found- resected.
 If foreign bodies are found- removed.

13. COMPLICATION
 1.Hypovolemia shock:
-Renal insuffficiency
-Pulmonary ventilation
2.Strangulation
3.Gangrene
4.Perforation

14. THANK YOU