Bowel Obstruction: Causes, Symptoms, and Complications

Bowel obstruction (intestinal obstruction) = mechanical or functional blockage preventing normal passage of intestinal contents.

Common Causes

• Adhesions (post‑surgical) – #1 cause in developed countries.
• Hernias (incarcerated/strangulated)
• Neoplasms (primary or metastatic)
• Volvulus (sigmoid, cecal)
• Intussusception (pediatric > adult)
• Strictures (Crohn's, radiation, NSAIDs)
• Fecal impaction
• Foreign bodies / bezoars

Symptoms

• Crampy abdominal pain (intermittent → constant)
• Nausea/vomiting (feculent in distal obstruction)
• Distension, tympany
• Obstipation (no stool/gas) or paradoxical diarrhea
• Fever, tachycardia if strangulation/ischemia

Complications

• Dehydration, electrolyte imbalance
• Bowel ischemia → perforation → peritonitis → sepsis
• Death if untreated

Imaging: upright abdominal X‑ray (air‑fluid levels), CT with contrast (gold standard). Management: NPO, NG decompression, IV fluids, surgery if complete/strangulated.