Abdominal pain
Colicky
Periumbilical or diffuse
Paroxysms of pain occur q5min
Vomiting
More common in proximal than distal obstruction
Bilious (proximal) or feculent (distal ileal)
Abdominal pain relieved with vomiting positively predictive +LR (4.50-2.82) -LR (0.78-0.35)
Abdominal distention
Seen more in distal than proximal obstruction
+LR (16.8-5.64) -LR (0.43-0.34)
Inability to pass flatus
May pass flatus/stool initially
Takes 12-24hrs for colon to empty
History of constipation +LR 8.8 and -LR 0.59
Dehydration
Anorexia
Ischemia (increased intraluminal pressure initially leads to venous obstruction, progresses to frank arterial ischemia)
Fever
Leukocytosis
Abnormal bowel sounds
Studies suggest that auscultating bowel sounds is not clinically useful to differentiate between normal and pathologic
Colicky
Periumbilical or diffuse
Paroxysms of pain occur q5min
More common in proximal than distal obstruction
Bilious (proximal) or feculent (distal ileal)
Abdominal pain relieved with vomiting positively predictive +LR (4.50-2.82) -LR (0.78-0.35)
Abdominal pain relieved with vomiting positively predictive +LR (4.50-2.82) -LR (0.78-0.35)
Seen more in distal than proximal obstruction
+LR (16.8-5.64) -LR (0.43-0.34)
May pass flatus/stool initially
Takes 12-24hrs for colon to empty
History of constipation +LR 8.8 and -LR 0.59
Takes 12-24hrs for colon to empty
History of constipation +LR 8.8 and -LR 0.59
Fever
Leukocytosis
Studies suggest that auscultating bowel sounds is not clinically useful to differentiate between normal and pathologic
Small bowel obstruction
Abdominal aortic aneurysm
Large bowel obstruction
Aortocaval fistula
Malignant bowel obstruction
Acute gastroenteritis
Epiploic appendagitis
Aortoenteric fisulta