Increased bowel sounds

Increased bowel sounds

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Differential Diagnosis

In alphabetical order.

• 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

• Electrolytes

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

References

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