Child health · UKMLA & AKT
Adhesional bowel obstruction
A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise adhesional bowel obstruction — the full SA Note notes add investigations, management, complications and 10 practice questions.
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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