Small Bowel Obstruction - Making the Diagnosis

What are the causes of small bowel obstruction?

How do you take a history in a patient with small intestinal obstruction?

What are the physical examination findings in a patient with small bowel obstruction?

Small bowel obstruction is a critical topic in general surgery and one of those subjects you'll encounter at least every week if not every day on surgery rounds.

Its important to understand how to think about the causes of bowel obstruction, generate a differential diagnosis and understand the pathophysiology!

MUST HAVE SURGERY BOOKS

In this discussion we're going to cover a clinical case which will demonstrate to you the dangers of magnets!

Check out these AMAZING timestamps and fast forward if you need to:

Start 00:00
Clinical Case of Small Bowel Obstruction 01:35
Causes of Small Bowel Obstruction 02:53
Pathophysiology of Small Bowel Obstruction 08:20
History Taking in Small Bowel Obstruction 13:08
Physical Examination in Small Bowel Obstruction 15:31
Reviewing the Clinical Case of Small Bowel Obstruction with Magnets 17:55

REFERENCES

WHO AM I?
I'm Dr. Erik Pearson, FACS and I am a board certified pediatric surgeon living in Las Vegas. I make surgical education videos on all topics in general surgery as well as talks on lifestyle design as a surgeon, book reviews, and studying effectively. I also write a weekly newsletter called the Saturday Six where I identify Six different discoveries of the week. You can get the weekly newsletter by signing up to the CITIZENSURGEON Community!

DISCLAIMER
While my aim is to help educate you for the ward, the surgical ICU, the operating room and your exams remember these videos are not a replacement for your reading, your medical school and residency preparation and most important your own decision making. If you have medical questions definitely consult a medical professional. Good luck and enjoy!

Affiliate Links - There are a few links in the description that may lead to a kickback to me to help support the channel.

[noraclark]

Just so nice to see such obvious passion for the work and the subject.

[JohnAdams-rmzm]

I had a small bowel obstruction from a past ruptured appendix surgery. I had the surgery after 2 days I got a fever of 106.9 and falling blood pressure. I was given last rites and my heart stopped and after I was converted back I was placed in a coma after the next 3 weeks were hell on earth very Sick and no control of my bowels the infection was very hard to control. I left the hospital weighing 109 lbs I’m 5’10” it was very tough learning to eat solid food again. But now I’m still alive and well✊😇

[peanut]

Dear God. I'm actually to scared to share my story, as I'm still not out of the woods yet. Was released yesterday, after 31 days in hospital. Complete obstruction. Pain was 11/10. Went into shock. Code blue. I literally dont know how I survived it. Pure hell on earth. At home...in recovery. Now i know what hell must be like.😢

[tendojohn]

Thanks Dr. This video was really elaborate

[felixgates]

Thanks. Great video and very educative

22 yrs ago I was diagnosed with Crohn’s disease, 4 moths later I was having major bowl resection due to a fistula going to my bladder.

I was sent home with major drugs and told I would have Crohn’s for the rest of my life. Within a month I weened myself off those drugs and began taking Cats Claw (herb from the Peruvian rain forest)

No prescription drugs or hospital stays since.

So no issues from 2000 to 2012 when I had my 1st experience with bowl obstruction.
I suffered for 8 hrs then went to ER. They took my history, X-ray then gave me an enema. I had a bowel movement then went home.

I’ve had numerous episodes since to which I immediately recognize the pain and act. My remedies are castor oil, orally (food grade) and externally via castor oil pack.
If those don’t work in a few hours I give myself an enema, these always have worked with time.

Less than 24-36 hours I’m pain free.
I also have since found the enzyme SERRAPEPTASE !
240, 000 spu daily!
I believe this enzyme is eating away my old scar tissue.

Hopefully I’ll have no more episodes.
I hope some of this information helps someone.

As always, a DR is never a last resort, one should learn their own body and to recognize an emergency situation, one should never disregard the obvious.

[lizardman]

I really enjoyed your structured breakdown of different causes for bowel obstruction! Great video!

[walterpaka]

One of the best videos on sbo. About to admit one and reviewing thus video for my case now. Thank you

[geegee]

I saw so many GPs about how distended and painful my abdomen gets and they never even checked for hernias, My gut feeling says there is an obstruction and this is how I ended up here. It all started during the pandemic in 2021 and It stopped passing gas. I am now in the middle of a trip to Europe and have no idea what to do after a horrible diarrhea episode where I got rid of so much fluid. I feel better and the diarrhea has stopped, but the pain never leaves me in the lower left-hand side. I have never vomited though. thank god!

[judebenish]

Good explanation. I had a small bowel obstruction ER surgery in Feb 2023. 10 days in hospital and about 2 month recovery at home but feeling back to normal.

[carolbenson]

Thank God someone explains this! Had surgery for small intestine issue due to scar tissue from a previous surgery. I'm recovering at home eating very mild foods and my strength and regular stools finally coming back.

[eyerusanbesse]

Great vedio thank you .please do other vedios on obstructive jaundice secondary to choledocholitiasis

[chadkosakowski]

I’ve been hospitalized 23 times for small bowel obstruction, it’s the worst pain ever!

[kfkww]

Dr Pearson. Love your videos. I'm learning more about SBO. I realize that your videos are aimed at the future Doctors and need to be in terminology used in the field. However, I'm just a silly-vilian with a smattering bit of medical knowledge. Is there a possibility you could develop videos that are more inline with our knowledge (or lack there of) to explain as a patient warning signs, anything a patient can do to mitigate SBO, or anything else that might be helpful? Thank you!

[angkrows]

Thanks so much for the video. Is it possible to feel an obstruction coming on? Idk if that sounds ridiculous or not. 5 yrs ago colon resection due to diverticulitis. 2 yrs ago bowel obstruction due to adhesions. Now for 3 months really distended, nausea, constipated. It feels like it did before. Is there anything I can do to be proactive? Would love to avoid another surgery.

[missadventuresmotorcycledi]

Watching in Ireland!
Thank you so much for this very informative video which is really giving me hope I have had constant lower abdominal pain for years now and it feels like it's getting worse. I had a total colectomy with IRA 8 years ago and I was a carer so I did not have time to recuperate. I have just been in constant pain I think I have adhesions but it's very hard to find a doctor who can help me. I'm really getting to the point of not being able to put up with it as I cannot lft carry or function anything like normal. it's getting me down, so I am very grateful for your video and being able to understand what's maybe going on a bit more. I feel pulling and squeezing from the inside and a barring down sessation. I drive a motorbike because I can't walk far with the pain.... I need to see a good specialist who can see pastthe fact that look healthy.

[joann]

I was sick with the stomach flu a month ago and had severe Diarrhea!! I took immodium for it however the diarrea continued after i was feeling better!! A few weeks ago i developed diarrea again took more immodium due to me having to go to work!! I developed severe abdominal pain and i couldnt pass gas. I was extremely nauseous. Pain would subside then flare up again. I couldnt even rub up against the counter it was so painful and painful to the touch!! I went to the ER. Cat scan done was diagnosed with SBO. Dr placed a NG tube for 24 hours!! Releived ALOT of Pain and pressure!!! Started passing gas. Dr done another Cat scan with Dye. Which gave me diarrea however my Small bowel unkinked itself!!
Looking back now I think i was sick for awhile cause i feel SO MUCH better!!! Havent had to take any Immodium at all since home been 2 weeks!! Eating normal and normal Bowel movements!! Be careful with Immodium it will Back you up!! ❤

[rajuchettri]

This is one of the best videos ever had.... because I was diagnosed with partial small bawl obstruction in Iraq, and they sent me to India for an endoscopy test. As a result of endoscopy and colonoscopy, my intestines are good in shape. Also, I had gone through CT scan where there is also normal. Could you please suggest me for further... because I'm psychologically down. Although, I don't have any problems as before.

[PouraniiEskandari-cqjm]

How can i know if i have endometriosis?

[loisrohling]

Dr. what kind of, tests, are performed, to find out, whether you have a, small bowel obstruction?