3. Pain
• 1st symptom, usually sudden
• Colicky nature
• Centered on the umbilicus (small bowel) or
lower abdomen (large bowel)
• Coincides with increased peristaltic activity
• Severe pain indicates presence of
strangulation
4. Vomiting
• The more distal the obstruction ,the longer the
interval between the onset of symptoms and
the appearance of nausea and vomiting.
• As obstruction progresses the character of
vomitus alters from digested food to faeculent
material.
5. Distension
• Degree of distension dependent on site
• The more distal the lesion greater is the
distension
6. Constipation
• Absolute (neither faeces nor flatus is passed)
cardinal feature of complete intestinal
obstruction
• Relative (only flatus is passed)
7. Other manifestations
• Dehydration : in small bowel obstruction
because of repeated vomiting
• Hypokalaemia
• Pyrexia : onset of ischemia
intestinal perforation
associated inflammation
hypothermia indicates septicaemic shock
• Abdominal tenderness
8.
9. Clinical features of strangulation
• Constant pain –pain never completely absent
• Tenderness with rigidity –indicates early
laparotomy
• Shock –indicates underlying ischaemia
10. Clinical features of intussusception
• Classical presentation –episodes of screaming
and drawing up of legs in previously well male
infant
• Vomiting –conspicuous and bile
stained
• ‘Redcurrant jelly’ stool
11. • Lump which hardens on palpation in 60%
• Feeling of emptiness in the right iliac fossa
(the sign of dance)
• On rectal examination blood stained mucus
may be found on the finger
• Unrelieved, progressive dehydration and
abdominal distension, followed by peritonitis
secondary to gangrene.
• D/D : a/c gastroenteritis
Henoch-Schoenlein purpura
Rectal prolapse