Large bowel svenska
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Mänskligt test
Bettina Lieske ; Marcelle Meseeha. Authors Bettina Lieske 1 ; Marcelle Meseeha. Large bowel obstruction usually presents as an emergency with sepsis, dehydration, and hemodynamically compromised state. The most common cause of large bowel obstruction is colorectal cancer. This activity explains the risk factors, evaluation, and management of large bowel obstruction and highlights the importance of an interprofessional team in enhancing care for affected patients.
Objectives: Identify the pathophysiology of large bowel obstruction. Outline the appropriate history and physical examination that should be done for patients with suspected large bowel obstruction. Summarize the treatment options available for patients with large bowel obstruction. Review interprofessional team strategies for improving care coordination and communication to advance care for patients with large bowel obstruction.
Access free multiple choice questions on this topic. Large bowel obstruction usually presents as an emergency.
Depending on the etiology, the patient may have had various symptoms before the acute presentation. Patients can potentially be very ill, septic, dehydrated, and hemodynamically and cardiovascularly compromised, especially if they have a competent ileocecal valve, which prevents decompression of the large bowel into the small bowel and leads to a closed-loop obstruction.
The most common cause of large bowel obstruction is an underlying colorectal malignancy. Benign causes of large bowel obstruction are strictures secondary to diverticular disease or inflammatory bowel diseases, as well as volvulus, most commonly of the sigmoid colon. Occasionally the sigmoid colon can get obstructed in a left inguinal hernia sac. External compression occurs most likely in the pelvis, secondary to gynecological malignancies.
Human test
Colorectal malignancies start occurring more commonly in the fifth decade of life, although the incidence of colorectal cancer has recently stabilized and is even slightly regressive in most parts of the developed world. There now appears to be an increase in presentation of patients younger than 50 with colorectal malignancies, and since this group of patients does not currently fall into screening recommendations, they may present with aggressive and advanced disease in the emergency setting.
Closed-loop obstruction is a surgical emergency. If inflow and outflow of the colon are both obstructed classical examples are a sigmoid volvulus or obstructing sigmoid colon cancer with a competent ileocecal valve , the obstructed bowel will continue to distend, owing to a significant amount of gas-forming bacteria trapped inside. This will eventually lead to vascular compromise, initially affecting the venous outflow, leading to further congestion until the arterial inflow ceases.
Vad är översättningen av "large bowel" på Svenska?
Ischaemia, necrosis and eventual perforation of the obstructed segment occur. The part of the colon most at risk of perforation is the caecum as it has the thinnest wall compared to other parts of the colon. While the colon is obstructed and distending, mucosal ischemia can lead to bacterial translocation of the gut flora, increasing the risk that the patient will present with bacteremia and sepsis.
Obstruction due to underlying colorectal malignancy tends to occur on the left side descending, sigmoid and rectum , as these are the more common locations for colorectal cancer. Also, the diameter of the bowel is smaller, and the feces tend to be solid. Patients may have experienced a change in bowel habit leading up to the obstruction, usually an alternating pattern of diarrhea and constipation, as only liquefied feces can pass through the narrowed lumen.
What is the translation of "bowel" in Swedish?
Questioning patients carefully about changes in their bowel patterns often reveals that symptoms have been present for weeks or months before the acute presentation. They may report bleeding per rectum in addition to the change in bowel habits. Patients presenting with obstruction will experience abdominal distension, abdominal discomfort and are unable to pass feces and ultimately flatus.
Patients may or may not have a positive family history of colorectal malignancy. Large bowel obstruction due to a sigmoid volvulus usually presents more acutely with abdominal distension rather than a change in bowel habit, and in patients who are less mobile and have a tendency for constipation, for example, nursing home residents and bedbound patients.