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Revision as of 14:02, 29 November 2012
| Increased bowel sounds |
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Increased Bowel Sounds Microchapters |
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Differentiating Increased Bowel Sounds from other Conditions |
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Diagnosis |
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Treatment |
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Case Studies |
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Increased bowel sounds On the Web |
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American Roentgen Ray Society Images of Increased bowel sounds |
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Risk calculators and risk factors for Increased bowel sounds |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Differential Diagnosis
In alphabetical order. [1] [2]
- Abscess
- Acute gastroenteritis
- Adhesions (from previous surgery)
- Benign etiologies
- Carcinoid syndrome
- Colonic-pseudo obstruction
- Crohn's disease
- Diarrhea
- Foreign body
- Gallstone ileus
- Hernias
- Hiatal hernia
- Infection
- Intussusception
- Lactase deficiency
- Malabsorption syndrome
- Mechanical bowel obstruction
- Neoplasms
- Peutz-Jeghers syndrome
- Succussion splash
- Volvulus
History and Symptoms
- Complete history is critical
Physical Examination
- Complete physical including rectal exam
- Vitals (for dehydration and fever)
- Sounds ascultated before palpation
Abdomen
- Exam should include hernia orifices and signs of incarceration and strangulation
Laboratory Findings
- Complete blood count (CBC)
- Calcium
- Glucose
- Amylase
- Blood urea nitrogen (BUN)/creatinine
- Liver function tests (LFTs)
- Lipase
- Urinalysis
Electrolyte and Biomarker Studies
X-Ray
- X-rays (flat and upright) are useful for urinalysis
MRI and CT
- Etiology is demonstrated best by abdominal CT scan
Other Diagnostic Studies
- Enteroclysis helps to determine degree of obstruction
Treatment
- Volume replacement of electrolytes and fluids
- No oral intake (partial obstructions)
- IV fluids (partial obstructions)
- Nasogastric decompression for partial bowel obstructions
Surgery and Device Based Therapy
- Complete bowel obstruction usually requires surgical intervention