Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- failure to pass flatus or stool
- abdominal pain
- vomiting
- abdominal distention
- abdominal tenderness
- absolute constipation
- peritonitis
- constipation
- palpable abdominal mass
- palpable rectal mass
Other diagnostic factors
- nausea
- fever
- tachycardia
- severe lethargy
- hypotension
- diarrhoea
- groin swelling
Risk factors
- previous abdominal surgery
- malrotation
- Crohn's disease
- hernia
- appendicitis
- intestinal malignancy
- intussusception
- volvulus
- intestinal atresia
- foreign body ingestion
Diagnostic investigations
1st investigations to order
- abdominal x-rays
- FBC
- urea
- electrolyte panel
- abdominal CT scan
Investigations to consider
- upper gastrointestinal x-ray with small bowel follow-through
- laparotomy
- laparoscopy
- abdominal ultrasound
- abdominal MRI
Treatment algorithm
Contributors
Authors
Consultant Colorectal Surgeon
Department of Coloproctology
St. Mark's Hospital
London
UK
Disclosures
JTJ declares that he has no competing interests.
Surgical Registrar and Clinical Research Fellow
St. Mark's Hospital
London
UK
Disclosures
ETP declares that he has no competing interests.
Honorary Clinical Lecturer
Department of Surgery and Cancer
Imperial College
London
UK
Disclosures
GM declares that he has no competing interests.
Dr John T. Jenkins, Dr Edward T. Pring, and Dr George Malietzis would like to gratefully acknowledge Dr Frances J. McNicol and Dr David J. Hackam, previous contributors to this topic.
Peer reviewers
Chief Academic Officer
Emeritus Chief of Staff (1997-2007)
Chairman Department of Colorectal Surgery
Professor of Surgery Ohio State University
Affiliate Professor Department of Surgery
Division of General Surgery
University of South Florida College of Medicine
Cleveland Clinic Florida
FL
Disclosures
SDW declares that he has no competing interests.
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