Intestinal obstruction

Intestinal obstruction, a disorder that afflicts both children and adults, is associated with significant morbidity. Early recognition and appropriate management can prevent life-threatening complications; however, considerable controversies exist regarding the ideal method of diagnosis and treatment. This article provides a comprehensive overview of risk factors for small and large bowel obstruction. The pathophysiologic process is related to the clinical findings. A summary of diagnostic methods with an evaluation of their relative merit is presented. Preventive, and medical, surgical, and palliative therapies are described, with an emphasis on the actions that an advanced practice nurse can implement.     

Bowel obstruction

Bowel obstruction is a serious problem requiring prompt medical intervention to relieve intestinal distention, restore intravascular volume, and correct fluid and electrolyte balance. If these efforts fail, either curative or palliative surgical interventions become necessary. Oncology nurses are important members of the healthcare team caring for patients with bowel obstructions. Accurate nursing assessments are critical to monitoring the effects of these therapies and key to reducing the risk of preoperative and/or postoperative complications.     

Small bowel obstruction

Gallstone ileus is a rare complication of cholelithiasis, but an established cause of mechanical small bowel obstruction in elderly patients. It is associated with high morbidity and mortality as most patients are elderly with multiple comorbidities. Surgery of choice is enterolithotomy.