Child health · UKMLA & AKT
Adhesional bowel obstruction
A free high-yield preview for the UKMLA Applied Knowledge Test, covering how to recognise this condition. The full SA Note notes add investigations, management and complications, with practice questions on this topic.
Key high-yield points
- Colicky central abdominal pain - cramping, comes in waves; quietens in late obstruction
- Vomiting - initially gastric, then bilious, then faeculent (prolonged obstruction)
- Abdominal distension - central (small bowel)
- Absolute constipation - failure to pass stool AND flatus
- Tinkling bowel sounds - high-pitched early; absent in late obstruction or strangulation
- Surgical scar - always ask about previous abdominal surgery
Features suggesting strangulation requiring urgent surgery: continuous (non-colicky) pain, fever and tachycardia out of proportion, peritonism (guarding, rebound, rigidity), raised lactate, markedly elevated CRP/WCC, failure to improve with conservative management.
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