Mechanical disruption in the small bowel, leading to significant clinical symptoms such as bilious or faeculent vomiting, abdominal pain and distension, and complete constipation

Aetiology

Factors outside the bowel

• Adhesions
  • Most common cause in the Western world
  • Prior intra-abdominal surgeries increase the risk of adhesion development. The larger the operation, the higher the likelihood of adhesion formation.
• Intra-abdominal hernia
  • Incarcerated hernias can precipitate acute obstruction

Factors relating to the bowel wall

• Crohn's disease
• Appendicitis

Factors relating to inside the bowel

• Malignancy
• Foreign body ingestion
• Gallstone ileus

Diseases causing small bowel obstruction in children

• Intussusception
• Volvulus
• Intestinal atresia
• Appendicitis

Clinical features

Symptoms

• Gastric outlet obstruction will present with vomiting of semi-digested food eaten a day or two previously (no bile)