Bowel obstruction classification: Difference between revisions
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==Overview== | ==Overview== | ||
Bowel obstruction may be classified by 5 different classification methods including: Open and closed, incomplete and complete, extrinsic, intrinsic and [[intraluminal]], true and [[Pseudo-obstruction-intestinal|pseudo-obstruction]], and finally, [[small bowel]] and [[large bowel]]. In this chapter, the extrinsic, intrinsic and [[intraluminal]] classification method will be used. | |||
==Classification== | ==Classification== | ||
Bowel obstruction may be classified as follows:<ref name="pmid3296252">{{cite journal |vauthors=Mucha P |title=Small intestinal obstruction |journal=Surg. Clin. North Am. |volume=67 |issue=3 |pages=597–620 |year=1987 |pmid=3296252 |doi= |url=}}</ref><ref name="pmid10971435">{{cite journal |vauthors=Miller G, Boman J, Shrier I, Gordon PH |title=Natural history of patients with adhesive small bowel obstruction |journal=Br J Surg |volume=87 |issue=9 |pages=1240–7 |year=2000 |pmid=10971435 |doi=10.1046/j.1365-2168.2000.01530.x |url=}}</ref> | |||
*'''Open or closed bowel''' | |||
** | **Open type of bowel obstruction refers to an [[obstruction]] at a single location where the rest of the [[bowel]] is patent. A closed bowel obstruction refers to an [[obstruction]] occurring at two locations, so that there is no [[proximal]] or [[distal]] outlet. | ||
*'''Complete or incomplete obstruction''' | |||
**Obstructions can either completely occlude the [[lumen]] of the bowel, or can partially (incompletely) occlude the [[bowel]]. | |||
*'''Extrinsic, intrinsic/intramural or intraluminal obstruction''' | |||
**An obstruction may be due to an external cause, for example, a [[tumor]] that pushes on the [[bowel]] from the outside. | |||
**An obstruction may be caused by an intrinsic (intramural) wall abnormality, for example, a [[tumor]] or [[Stenosis|stricture]] or [[hematoma]]. | |||
**An [[intraluminal]] obstruction describes the process by which a luminal defect prevents the normal passage of bowel contents, for example, a [[foreign body]], [[gallstone]] or an [[intussusception]]. | |||
*'''Small or large bowel obstruction''' | |||
** | **[[Small bowel]] obstruction include obstructions that occur along the [[duodenum]] up to the [[ileocecal]] junction, obstructions beyond this junction are classified as [[Colon (anatomy)|large bowel]] obstructions. A subset of large bowel obstruction includes outlet obstructions. | ||
*'''True or pseudo-obstruction''' | |||
**[[Ogilvie syndrome|Ogilvie's syndrome]] and adynamic ([[Paralytic ileus|paralytic]]) [[ileus]] represent pseudo-obstructions, and are not true mechanical obstructions as the [[bowel]] is dilated and patent but [[intestinal]] contents are not able to pass. | |||
'''<u>Bowel obstruction classification algorithm:</u>''' | |||
{{Family tree/start}} | |||
{{Family tree | | | | | | | | A01 | | | | |A01= Bowel obstruction classification}} | |||
{{Family tree | |,|-|-|-|v|-|-|^|-|-|v|-|-|-|v|-|-|-|.| | | | | | | |}} | |||
{{Family tree | B01 | | B02 | | | | B03 | | B04 | | B05 | | | | | |B01='''Open''' or '''Closed'''|B02='''Large''' bowel or '''Small''' bowel| B03='''Extrinsic''' or '''Intrinsic''' or '''Intraluminal'''|B04='''Complete''' or '''Incomplete'''|B05='''True''' or '''Pseudo''' obstruction}} | |||
{{Family tree | | | | | |!| | | }} | |||
{{Family tree | | | | | C01 | |C01='''Outlet obstruction''' (a subset of large bowel obstruction)}} | |||
{{Family tree/end}} | |||
==References== | ==References== | ||
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Latest revision as of 16:28, 26 February 2018
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Bowel obstruction Microchapters |
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Bowel obstruction classification On the Web |
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Risk calculators and risk factors for Bowel obstruction classification |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]
Overview
Bowel obstruction may be classified by 5 different classification methods including: Open and closed, incomplete and complete, extrinsic, intrinsic and intraluminal, true and pseudo-obstruction, and finally, small bowel and large bowel. In this chapter, the extrinsic, intrinsic and intraluminal classification method will be used.
Classification
Bowel obstruction may be classified as follows:[1][2]
- Open or closed bowel
- Open type of bowel obstruction refers to an obstruction at a single location where the rest of the bowel is patent. A closed bowel obstruction refers to an obstruction occurring at two locations, so that there is no proximal or distal outlet.
- Complete or incomplete obstruction
- Extrinsic, intrinsic/intramural or intraluminal obstruction
- An obstruction may be due to an external cause, for example, a tumor that pushes on the bowel from the outside.
- An obstruction may be caused by an intrinsic (intramural) wall abnormality, for example, a tumor or stricture or hematoma.
- An intraluminal obstruction describes the process by which a luminal defect prevents the normal passage of bowel contents, for example, a foreign body, gallstone or an intussusception.
- Small or large bowel obstruction
- Small bowel obstruction include obstructions that occur along the duodenum up to the ileocecal junction, obstructions beyond this junction are classified as large bowel obstructions. A subset of large bowel obstruction includes outlet obstructions.
- True or pseudo-obstruction
- Ogilvie's syndrome and adynamic (paralytic) ileus represent pseudo-obstructions, and are not true mechanical obstructions as the bowel is dilated and patent but intestinal contents are not able to pass.
Bowel obstruction classification algorithm:
| Bowel obstruction classification | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Open or Closed | Large bowel or Small bowel | Extrinsic or Intrinsic or Intraluminal | Complete or Incomplete | True or Pseudo obstruction | |||||||||||||||||||||||||||||||||||||||||||||||||||
| Outlet obstruction (a subset of large bowel obstruction) | |||||||||||||||||||||||||||||||||||||||||||||||||||||||
References
- ↑ Mucha P (1987). "Small intestinal obstruction". Surg. Clin. North Am. 67 (3): 597–620. PMID 3296252.
- ↑ Miller G, Boman J, Shrier I, Gordon PH (2000). "Natural history of patients with adhesive small bowel obstruction". Br J Surg. 87 (9): 1240–7. doi:10.1046/j.1365-2168.2000.01530.x. PMID 10971435.