Large bowel obstruction
Cause
• Neoplasm
• Inflammation eg. Diverticulitis
• Volvulus
• Hernia
• Anal stenosis
• Normal transverse colon diameter < 5.5 cm
• Dilatation of colon proximal to the obstruction
• Decreased gas distal to the obstruction
• Fluid level in the transverse or Lt.sided- colon
• cecum diameter > 9 cm: prone to perforation
• Gas-filled dilated
large bowel from
cecum to distal
descending colon
LBO แบ่งได้ 2 แบบ
• Type 1 : Competent ileocecal valve
– Type 1A : dilate colon and cecum, no small bowel
dilate
– Type 1B : Type 1A ทอ่ี ุดตนั นานๆ ทาให้ small bowel
dilate ได้
• Type 2 : Incompetent ileocecal valve
no cecum and ascending colon dilatation,
small bowel dilate
Large bowel volvulus
• Closed loop obstruction
• มักพบบริเวณ sigmoid colon, cecum, transverse
colon
• A large air-filled sigmoid loop arising from the
pelvis and extending cranially beyond the level
of the transverse colon
• Inverted U-shaped (Coffee bean sign)
• Closed loop
Gastric outlet obstruction
• Causes : peptic ulcer
carcinoma
• Dilatation of stomach
• Decreased distal bowel gas
• Displaced transverse colon
• Mottling appearance of foods
The End
Thank you