Intestinal obstruction is a partial or complete blockage of the bowel that prevents the contents of the intestine from passing through.
Obstruction of the bowel may due to:
Paralytic ileus, also called pseudo-obstruction, is one of the major causes of intestinal obstruction in infants and children. Causes of paralytic ileus may include:
Mechanical causes of intestinal obstruction may include:
During a physical exam, the health care provider may find bloating, tenderness, or hernias in the abdomen.
Tests that show obstruction include:
Treatment involves placing a tube through the nose into the stomach or intestine to help relieve abdominal swelling (distention) and vomiting. Volvulus of the large bowel may be treated by passing a tube into the rectum.
Surgery may be needed to relieve the obstruction if the tube does not relieve the symptoms, or if there are signs of tissue death.
The outcome depends on the cause of the blockage. Most of the time the cause is easily treated.
Complications may include or may lead to:
If the obstruction blocks the blood supply to the intestine, it may cause infection and tissue death (gangrene). Risks for tissue death are related to the cause of the blockage and how long it has been present. Hernias, volvulus, and intussusception carry a higher gangrene risk.
In a newborn, paralytic ileus that destroys the bowel wall (necrotizing enterocolitis) is life-threatening and may lead to blood and lung infections.
Call your health care provider if you:
Prevention depends on the cause. Treating conditions, such as tumors and hernias, that can lead to obstruction may reduce your risk of getting an obstruction.
Some causes of obstruction cannot be prevented.
Paralytic ileus; Intestinal volvulus; Bowel obstruction; Ileus; Pseudo-obstruction - intestinal; Colonic ileus
McKenzie S, Evers BM. Small intestine. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. St. Louis, Mo: WB Saunders; 2012:chap 50.
Fry RD, Mahmoud N, Maron DJ, Bleier JIS. Colon and rectum. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. St. Louis, Mo: WB Saunders; 2012:chap 52.
Turnage RH, Heldmann M. Intestinal obstruction. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 119.
Updated by: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington; and Joshua Kunin, MD, Consulting Colorectal Surgeon, Zichron Yaakov, Israel. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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