Causes and risk factors
Causes of intestinal strangulation include strangulated hernia, pelvic inflammatory disease, diverticular disease, appendicitis, hepatitis, peritonitis, etc.
Clinical presentation
Patient presents with abdominal pain and tenderness. Cramping in abdomen is experienced. Abdominal distention occurs. Fever, nausea, and vomiting can occur. An urgent need to defecate, diarrhea, blood in stools may occur. There is rapid pulse and tachycardia observed. There may be presence of an abdominal lump. Sepsis can occur if the condition is left untreated.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Routine blood test is done. Abdominal x-ray shows presence of multiple gas-fluid levels and distended bladder. Ultrasound of abdomen is advised. Colonoscopy, endoscopy, or laparoscopy is recommended. CT scan of abdomen helps to diagnose the exact cause of the obstruction.
Treatment
Intestinal strangulation is a medical and surgical emergency. Treatment consists of surgical procedure in which the strangulation is exposed, adhesions are removed and the herniated intestine is reduced. In severe cases, removal of dead tissues or bowel resection, i.e., removal of affected part of colon may be required. Postoperative care with analgesics, antibiotics, and IV fluid is required.
