Intestinal obstruction is a serious condition caused by a violation of the movement of intestinal contents through the digestive tube due to a mechanical obstacle, which is a tumor in the intestine itself or in the abdominal cavity.
Clinical syndrome is especially characteristic of patients with intestinal cancer, 15–20% learn about the disease for the first time after an emergency operation for acute obstruction.
Intestinal Obstruction Cause
The main cause of intestinal obstruction is the overlapping of the intestinal lumen with a cancer tumor or compression of the intestinal tube from the outside by tumor nodes in the abdominal cavity, which often happens in ovarian cancer.
In cancer patients, the overwhelming majority of them are obstructed by cancer of the colon, since malignant neoplasms of the small intestine are very rare.
At first, intensively contracting, the blocked gut tries to push through hard fecal masses to no avail, strongly stretches above the site of the block and falls into nervous paralysis. Through the paralyzed sluggish intestinal wall, toxic products are absorbed into the blood, leading to severe intoxication and oxygen starvation of tissues — polyorgan failure.
The onset of the disease is rather slow, but up to a certain limit, when an enormous amount of microelements, proteins and fluids are lost with emetic masses, poisoning with decomposition products — endotoxicosis — is clinically manifested.
Together with toxins from the lumen of the necrotic bowel bacteria enter the blood, and peritonitis begins in the abdominal cavity with the formation of inflammatory infiltrates and abscesses — abscesses.
In the abdominal cavity, the pressure rises sharply, which is called «compartment syndrome», which additionally disrupts the blood supply to the starving internal organs.
Intestinal Obstruction Diagnostics
Obstruction may be partial, when not the entire lumen of the intestine overlaps, evacuation of liquid contents is possible with a passage width of just one centimeter. In the lower parts of the colon, when all the liquid has sucked from the contents, such a small lumen leads to catastrophic consequences more quickly.
You can suspect the disease by the symptoms and appearance of the patient. Diagnosis of obstruction consists in abdominal radiography revealing typical symptoms, the most characteristic of which is the «Kloyber bowl». On the survey radiograph in the lumen of the intestine will be visible inverted cup with liquid and a gas bubble above it. The small intestine swollen like an arch, transfusion of liquid contents in intestinal loops in the absence of gases in them can be determined.
In doubtful cases, a CT scan or MRI scan of the abdominal cavity must be done to make a diagnosis. Endoscopy — colonoscopy determines the level of the lesion and the diameter of the narrowing, which is important for developing tactics of surgical intervention, and also take a biopsy when performing unloading stenting at the first stage.
Timely diagnosis of severe, but not uncommon, complications of colorectal cancer allows for optimal treatment while maintaining the integrity of the intestinal tube, which will make life long and qualitatively different.