ABSTRACT
Colicky abdominal pain, distension, vomiting, and absolute constipation are the cardinal features of bowel obstruction. The features will vary according to the site of the obstruction and the underlying pathology. Abdominal distension is dependent on the level of the obstruction, and will be greater in distal lesions, particularly of the large bowel. Visible peristalsis may also be present. Adhesions are the commonest cause of obstruction (50–60% of cases). Approximately 5% of all patients undergoing laparotomy will develop symptomatic postoperative adhesions. In simple bowel obstruction there is bowel dilatation proximal to the obstruction, which results in gas and fluid accumulation within the bowel wall and lumen. Localised guarding and rebound tenderness suggest strangulation or perforation of the bowel. The chapter describes the principles of management of bowel obstruction.
