Fact-sheet: Colonic obstruction
Updated on 03/12/2018 at 4:52 PM
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Definition
Colonic obstruction
Clinical features
Clinical signs of bowel obstruction:
- abdominal pain
- classically late-onset vomiting
- cessation of flatus and bowel movements
- often marked abdominal distension
CT
Reference examination for the workup of bowel obstruction.
Positive diagnosis of mechanical colonic obstruction:
-colonic distension greater than 6 cm.
-presence of a lesion causing a caliber discrepancy between a dilated upstream colonic segment and a normal or collapsed downstream segment.
Diagnosis of severity:
-cecal distension (> 12 cm)
-competent ileocecal valve
-pneumatosis intestinalis
-mesenteric or portal venous gas
-lack of wall enhancement (major sign)
-pneumoperitoneum indicating perforation
Etiologies of mechanical obstruction:
-wall-related cause: adenocarcinoma, acute diverticulitis, colonic endometriosis
-strangulation: sigmoid or cecal volvulus, colonic hernia
-endoluminal cause: fecal impaction