gastrointestinal disorders
Intestinal Obstruction
Key Points
The most common causes of obstruction are adhesions, hernias, and tumors; a small-bowel obstruction in the absence of prior surgery or hernias is often caused by a tumor. Vomiting and third spacing of fluid cause volume depletion. Prolonged obstruction can cause bowel ischemia, infarction, and perforation. Use nasogastric suction and IV fluids prior to surgical repair. Consider a trial of nasogastric suction rather than immediate surgery for patients with recurrent obstruction due to adhesions. 