Diagnosing Small Bowel Obstruction Made Easy
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- čas přidán 19. 05. 2024
- What are the causes of small bowel obstruction?
How do you take a history in a patient with small intestinal obstruction?
What are the physical examination findings in a patient with small bowel obstruction?
Small bowel obstruction is a critical topic in general surgery and one of those subjects you'll encounter at least every week if not every day on surgery rounds.
Its important to understand how to think about the causes of bowel obstruction, generate a differential diagnosis and understand the pathophysiology!
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In this discussion we're going to cover a clinical case which will demonstrate to you the dangers of magnets!
Check out these AMAZING timestamps and fast forward if you need to:
Start 00:00
Clinical Case of Small Bowel Obstruction 01:35
Causes of Small Bowel Obstruction 02:53
Pathophysiology of Small Bowel Obstruction 08:20
History Taking in Small Bowel Obstruction 13:08
Physical Examination in Small Bowel Obstruction 15:31
Reviewing the Clinical Case of Small Bowel Obstruction with Magnets 17:55
REFERENCES
Sabiston's Textbook of Surgerycitizensurgeon.co/Sabiston
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Cameron's Surgery citizensurgeon.co/Cameron
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I'm Dr. Erik Pearson, FACS and I am a board certified pediatric surgeon living in Las Vegas. I make surgical education videos on all topics in general surgery as well as talks on lifestyle design as a surgeon, book reviews, and studying effectively. I also write a weekly newsletter called the Saturday Six where I identify Six different discoveries of the week. You can get the weekly newsletter by signing up to the CITIZENSURGEON Community!
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While my aim is to help educate you for the ward, the surgical ICU, the operating room and your exams remember these videos are not a replacement for your reading, your medical school and residency preparation and most important your own decision making. If you have medical questions definitely consult a medical professional. Good luck and enjoy!
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I had a small bowel obstruction from a past ruptured appendix surgery. I had the surgery after 2 days I got a fever of 106.9 and falling blood pressure. I was given last rites and my heart stopped and after I was converted back I was placed in a coma after the next 3 weeks were hell on earth very Sick and no control of my bowels the infection was very hard to control. I left the hospital weighing 109 lbs I’m 5’10” it was very tough learning to eat solid food again. But now I’m still alive and well✊😇
Wow, you were so sick, thank you for sharing your story, I’m glad you made a strong recovery!
@@citizensurgeon Thanks Dr, plus from 2019-2021 I had 3 ablations for afib heart doing great ✊
You talk to us like your talking to another doctor. You lost me at hello. 😊
Hi can u please tell me from where u got your treatment
Thanks Dr. This video was really elaborate
I really enjoyed your structured breakdown of different causes for bowel obstruction! Great video!
So cool! Thanks so much for the feedback! If you start to think of problems in a systematic way instead of memorizing lists your ability to generate a differential diagnosis will sky rocket!
Just so nice to see such obvious passion for the work and the subject.
Thanks so much Nora! I love putting together these videos and connecting with people around the world...those that love surgery and sometimes just those who love learning
One of the best videos on sbo. About to admit one and reviewing thus video for my case now. Thank you
Awesome thanks so much for the feedback! Next week I’ll have the video out on workup and treatment! Good luck!
Good explanation. I had a small bowel obstruction ER surgery in Feb 2023. 10 days in hospital and about 2 month recovery at home but feeling back to normal.
I had a similar experience. My surgery was early March 2024.
Watching in Ireland!
Thank you so much for this very informative video which is really giving me hope I have had constant lower abdominal pain for years now and it feels like it's getting worse. I had a total colectomy with IRA 8 years ago and I was a carer so I did not have time to recuperate. I have just been in constant pain I think I have adhesions but it's very hard to find a doctor who can help me. I'm really getting to the point of not being able to put up with it as I cannot lft carry or function anything like normal. it's getting me down, so I am very grateful for your video and being able to understand what's maybe going on a bit more. I feel pulling and squeezing from the inside and a barring down sessation. I drive a motorbike because I can't walk far with the pain.... I need to see a good specialist who can see pastthe fact that look healthy.
Thanks for sharing your story and engaging! I wish you the best recovery ahead!
Great vedio thank you .please do other vedios on obstructive jaundice secondary to choledocholitiasis
Thanks so much, will get that on deck!
fantastic lectures!
Thank you!!
great video
Thanks Dave! Glad you enjoyed it!
Thanks doc❤
Yes indeed glad you liked it!
You are a doll!
Thank God someone explains this! Had surgery for small intestine issue due to scar tissue from a previous surgery. I'm recovering at home eating very mild foods and my strength and regular stools finally coming back.
Thank you Carol, glad to hear you are recovering well!
I saw so many GPs about how distended and painful my abdomen gets and they never even checked for hernias, My gut feeling says there is an obstruction and this is how I ended up here. It all started during the pandemic in 2021 and It stopped passing gas. I am now in the middle of a trip to Europe and have no idea what to do after a horrible diarrhea episode where I got rid of so much fluid. I feel better and the diarrhea has stopped, but the pain never leaves me in the lower left-hand side. I have never vomited though. thank god!
Its not an obstruction, if it was u wouldn't be able to function at all...
1. Take lugols iodine. It'll kill infection
2. Eat cow intestine.
3. Eat meat and fat.
4. Stop all fiber and vegetables
Hi
I have same problem currently in hospital CT scan, colonoscopy and gastroscopy couldn't pick up what the problem with my stomach. Am feeling gas movement only when i pass or pass loose stool i get relief from pain on my left side.. i definitely suspect small intestine obstruction not sure what other test to do so doctor can see the problem
@@mooremusariri2823 start with magnesium glysinate. Also lugols iodine
Hi can u please tell me from where u got your treatment
This is one of the best videos ever had.... because I was diagnosed with partial small bawl obstruction in Iraq, and they sent me to India for an endoscopy test. As a result of endoscopy and colonoscopy, my intestines are good in shape. Also, I had gone through CT scan where there is also normal. Could you please suggest me for further... because I'm psychologically down. Although, I don't have any problems as before.
السلام عليكم صديقي اني هم من العراق وين شخصوك اني اشك انه عندي انسداد جزئي مثلك والسي تي والسونار ميبين بيهن شي
Same with me. Years of doctors and no diagnosis. Still in pain after years
Hi can u please tell me from where u got your treatment
Please tell me what a collapsed distal colon means? Thank you Doctor.
Went to the doctor yesterday, they told me I had inflammation In my small an large intestines. I'm trying to see what cause this and is it something I should be worried about?
How can i know if i have endometriosis?
Thanks so much for the video. Is it possible to feel an obstruction coming on? Idk if that sounds ridiculous or not. 5 yrs ago colon resection due to diverticulitis. 2 yrs ago bowel obstruction due to adhesions. Now for 3 months really distended, nausea, constipated. It feels like it did before. Is there anything I can do to be proactive? Would love to avoid another surgery.
I’m sorry you’re struggling with this, each case is a bit different and unfortunately given the complexity of this and the platform I can’t give medical advice. I would check in with your family practice doc and get a plan that first addresses the constipation, perhaps all you need is to stay hydrated with some miralax, but that is certainly between you and your doc. Good luck!
I was sick with the stomach flu a month ago and had severe Diarrhea!! I took immodium for it however the diarrea continued after i was feeling better!! A few weeks ago i developed diarrea again took more immodium due to me having to go to work!! I developed severe abdominal pain and i couldnt pass gas. I was extremely nauseous. Pain would subside then flare up again. I couldnt even rub up against the counter it was so painful and painful to the touch!! I went to the ER. Cat scan done was diagnosed with SBO. Dr placed a NG tube for 24 hours!! Releived ALOT of Pain and pressure!!! Started passing gas. Dr done another Cat scan with Dye. Which gave me diarrea however my Small bowel unkinked itself!!
Looking back now I think i was sick for awhile cause i feel SO MUCH better!!! Havent had to take any Immodium at all since home been 2 weeks!! Eating normal and normal Bowel movements!! Be careful with Immodium it will Back you up!! ❤
I spent 4 days in the ER after being diagnosed with SBO. NG tube was in for two days no food or water. Was released day after ct scan with dye. I’m back home no more pain but definitely not back to normal.
I got like this too after having some type of 'flu', i wonder if I had covid? I lost all, and I mean all, my taste and smell and I started taking decongestants, and that is when this started, so thinking the meds constipated me, but the cramping and all was so bad I assumed I ate something that gave me a bacterial infection and well it's just all been down hill from there. 5 weeks now.
Hi can u please tell me from where u got your treatment
Hello ive been following you for a while but its a bit complicated to understand the terms. Is it possible for u to do a vid for basic terms?
That’s awesome, thanks for following! Give me a few examples and that will help me make a solution!
@@citizensurgeon for example what the names of cuts are and how to know the names of vains and muscles. I just want to know the basics.
I had four surgeries for mid gut malrotation. Bowel obstructions are very painful and a person should go to ER if they have an obstruction. The pain builds to a crescendo then backs off only to return minutes later. Passing blood and vomiting blood are bad signs. Racing heartbeat .
how bout the signs and symptoms of it pleaseeee... Just had surgery a year ago right ovary endometriosis.. endo might gone for now.. but feeling a little heat in my right side back and tru rib cage something bring me to search it and end up to your video..
I would certainly visit your doctor, the symptoms can vary quite a bit from significant abdominal pain and vomiting and signs such as a distended and tender abdomen to softer more vague symptoms in a partial obstruction, certainly visit your doctor and figure that out
Would bowel obstruction cause a burning sensation feel like on outside of stomach
Hi Dr,
I’m a fit and healthy 38 year old woman and I’ve had bad back pain, a very bloated stomach and stomach cramps for weeks. I had an x ray and my doctor said I had some air pockets in my small bowel. There was no follow up? I’m still uncomfortable. Should I be concerned and follow up to get a specialists appointment?
Thanks :)
How are you feeling now? 🙏
I am in a similar boat and just had surgery. If I were you I would order a total free testosterone test from an independent lab. In women a common cause is ovarian cysts/endometriosis which often cause irregularities in hormones. This was the only test that popped up as irregular for me and eventually lead to surgery.
Dr. what kind of, tests, are performed, to find out, whether you have a, small bowel obstruction?
A solid history and physical exam starts it off, then a plain film X-ray can show dilated loops finally a ct scan can be helpful in identifying a transition point
Hi doctor;I am from burma,I had 2 surgery because of bowel obstruction caused by adhesion.I would like to know how can I prevent adhesive bowel obstruction?Please answer me.I am not afraid to have surgery but i do afraid to feel such intense pain.I am totally fine right now but I am concern that it will come again.Thank you.
Adhesive bowel obstruction is common and yes there is a high recurrence risk. Here is a segment from an article in annals of surgery and the link to read more…
Since 1990, it has been reported that adhesive SBO occurs in 3% of all laparotomies, 1% during the first postoperative year.6,7 After operated adhesive postoperative SBO, a risk of recurrence remains and the literature reported a wide ranging rate of overall recurrence (range, 8.7%-53%) at 3 years and more.
www.ncbi.nlm.nih.gov/pmc/articles/PMC1856591/
Hey doctor my name is Jacob. A few days ago on Monday I was suffering from sulfur burps with mild stomach pain on lower left side on Tuesday after I ate I had diarrhea two times and once pooped out mucus couldn't pass gas or have bowel movement since then last night I farted several times and the lower left side pain was relieved bloating went away but I still haven't had a bowel movement should I eat more? Ive been eating mostly soup and chicken broth with plenty of water since Tuesday. Thank you for your video
Hi Jacob, thanks for your question and it seems like this could be gastroenteritis versus constipation but you've got to see a physician or visit a clinic to make sure. Good luck and I hope this resolves!
@citizensurgeon Thanks doctor that's what they diagnosed me with on 7/22/23 they checked me and said it's no blockage and everything looks healthy except my high sugar but I still have diarrhea from time to time since my visit last week
Hi doctor. I don't use the bathroom on a regular basis. Seems like every other month my bowel breaks down with diarrhea, pain on right side of abdomen, cold sweat and fingers locking. It was so severe this time my son called the paramedics. My doctor will not refer me to a specialist. She suggested miralex. I'm really scared as this is day 4 of no bm taking miralex. I feel there's a blockage somewhere. I had gallstone surgery in 2018. My symptoms are getting worse. Any suggestions?
How are you feeling? Have the found anything?
1. Stop all veg and fiber
2. Take lugols iodone, kills infections
3 eat more fat. Some foods only
I currently am experiencing not having a bowel movement for 3 days now. When I eat throw ever thing back up and I get dizzy. I am starting to feel I need to have a bowel movement. I have been on a liquid diet for the pass two days.
Oxy powder works well
22 yrs ago I was diagnosed with Crohn’s disease, 4 moths later I was having major bowl resection due to a fistula going to my bladder.
I was sent home with major drugs and told I would have Crohn’s for the rest of my life. Within a month I weened myself off those drugs and began taking Cats Claw (herb from the Peruvian rain forest)
No prescription drugs or hospital stays since.
So no issues from 2000 to 2012 when I had my 1st experience with bowl obstruction.
I suffered for 8 hrs then went to ER. They took my history, X-ray then gave me an enema. I had a bowel movement then went home.
I’ve had numerous episodes since to which I immediately recognize the pain and act. My remedies are castor oil, orally (food grade) and externally via castor oil pack.
If those don’t work in a few hours I give myself an enema, these always have worked with time.
Less than 24-36 hours I’m pain free.
I also have since found the enzyme SERRAPEPTASE !
240,000 spu daily!
I believe this enzyme is eating away my old scar tissue.
Hopefully I’ll have no more episodes.
I hope some of this information helps someone.
As always, a DR is never a last resort, one should learn their own body and to recognize an emergency situation, one should never disregard the obvious.
Hey, just recovering from surgery for small bowel obstruction. My surgeons essentially said a tumor was the reason I was having a small bowel obstruction and they don't know how I got it. Been discharged from hospital since May 4.
Sorry to hear you were admitted for an obstruction and a cancer causing it, I wish you a very quick recovery and hope you are now cancer free! Thank you for engaging and sharing your story!
@@citizensurgeon Luckily it was a benign tumor, so I'm good.
That’s good to hear!
Please was the surgery painful
@Humble Humble no I was put to sleep
Can one contact you privately
I’m sorry I can’t provide medical advice or form a doctor patient relationship, my aim is to provide education and information, I hope you can take your questions to your doctor and get some answers.
The doctors in the ER were so attentive to me and my son who knows my eating habits and virtually EVERYTHING that I've Consumed for the last 90 days. Transferred to the main hospital, the doctors and nurses are totally disinterest in anything he has to say. I'm 98 years old and I'm afraid that they are killing me. Each procedure that they do seems to call for yet another procedure that is leaving me so weak my voice has changed and they won't give me a mirror so I can see why all of my friends and family cry upon seeing me. My son says they are not considering my last months history while treating me as they would a much younger person. This process and procedure is killing me and I'm not ready to die yet. I planned on living to 107 HELP ME PLEASE!
I’m sorry to hear that Grace, I wish you the very best in your recovery.
TY for your well wishes,sincerely!
However a suggestion for another opinion would make feel encouraged to sign myself out. My sons asked to RECORD my stay and was read the Hippa laws. Interesting because it would be our word against theirs. Their " take " is a story of contradiction and mistakes.
@@graceaccardi6327 I truly hope you're out of that hospital and recovering well at home. Most Drs are not concerned with helping us , and very few people care about other's anymore. One tip ; you're better off at home if at all possible , get away from there . Tell your son to read about HIPPA very eye opening. I hope your well and having a great day...
I am prone to obstruction due to having Crohn's and ulcerative colitis. I've had four bowel resections so far and because my guts like to develop adhesions, I know I will have to have more. I can attest that it is the worst pain I've ever felt. I have given birth, had kidney stones, and broken bones and will gladly take any one of those over a small bowel obstruction. Thank you for what you do. 💕
Thanks for sharing such a personal story, Crohn’s is a difficult disease to treat and I’m sure incredibly difficult personally for many reasons, I sincerely hope you have no surgeries in the future, thank you again for watching and sharing
@@citizensurgeon Is it true when you have surgery for bowel obstruction that it can cause a lot more serious symptoms for the person?
Going through the same thing .hopefully you're doing better. I wanted to ask you what do you eat? I'm looking for the right foods to eat to prevent suffering
@@mattk5020 yes it's true. I have a problem with obstruction due to adhesions that form from scar tissue. Unfortunately for me, these surgeries are the only way for me to stay on the side of the living, but if they are not absolutely necessary I do not recommend starting.
@@jayson3994 Thank you, and I am doing better ❤️ as far as foods go, there are times when I have to stick to liquids for a little bit, but on my "good" days I stay away from roughage like lettuce and raw veggies. Onion in any form can be quite inflaming, and most people have problems with dairy. I fortunately don't have that problem though. Stay well!
Megacolon toxi😊c😢
Absolutely
8 hours in ane after 12 days of crippling pain to be sent home with gaviscon and a doctor touching my gut
That sounds very frustrating, I empathize with you, partial bowel obstructions that resolve without can be very difficult and painful, happy to hear you e recovered
@@citizensurgeon I've not that's my point
Wasn't interested gave a evaluation with touching my stomach no scans nothing
why on earth would a man of sound mind swallow magnets? Maybe he was mentally disabled? Why would you go to the ER with that and be like, oh, I have no idea what is wrong with me, lol, that whole thing sounds odd. I wish mine were that simple, I have no idea what is wrong w me at this point. :(
Seems like he's speaking amongst other Doctors. Just speak in common English please
Thanks for the feedback, my intended audience is medical students and surgical trainees so the language is tilted a bit on the spectrum, I’m pumped that you found value in the video, let me know what language I can clear up! Thank you again.