Intestinal Obstruction

Clinical features

Proximal small bowel: vomiting closely follows onset of pain (hours).
Distal small bowel: vomiting occurs one or two days after onset of pain.
Large bowel: vomiting may be absent. Distension predominates.

Appearance of vomitus is also helpful:
Semidigested food: gastric outlet obstruction.
Bile stained: proximal small bowel.
Faeculent: distal small bowel.


Fluid resuscitation, then


  • Perforation (esp. closed loop syndrome)