4. A portion of the SI becomes entrapped in one
of the retroperitoneal fossae or in a congenital
mesenteric defect
Sites
Foramen of Winslow
Holes in the mesentery or transverse
mesocolon
Defect in the broad ligament
Diaphragmatic hernia
Duodenal/caecal/appendiceal
retroperitoneal fossae
7. 1. Gall stones
In the elderly
20 to erosion of a large gallstone through
the gallbladder into the duodenum
Classically there is impaction about 60 cm
proximal to the ileocaecal valve
8. 2. Food
Occur after partial or total gastrectomy when
unchewed articles can pass into the small
bowel
3. Stercolith
In association with jejunal diverticulum or ileal
stricture
9. 4. Trichobezoar
Firm masses of undigested hair balls
Associated with an underlying psychiatric
abnormality
10. 5. Phytobezoar
Firm masses of fruit or vegetable fibres
Predisposing factors
High fibre intake
Inadequate chewing
Previous gastric surgery
Hypochlorhydria
Loss of the gastric pump mechanism
11. 6. Worms
Ascaris Lumbricoides
In children
An attack frequently follows the initiation of
antihelminthic therapy
12. Common cause of intestinal obstruction in
western countries
Any peritoneal irritation → local fibrin
production → adhesions between opposed
surfaces
Causes
Ischemic areas- Sites of anastomoses, trauma
vascular occlusion
Foreign material- Talc , starch, gauze, silk
Infection- Peritonitis, tuberculosis
Inflammatory conditions- Crohn’s disease
Radiation enteritis
13.
14.
15. INTUSSUSCEPTION
One portion of the gut becomes invaginated
within an immediately adjacent segment
Commonly in children(5-10 months)
90% idiopathic
Secondary to intestinal pathology. Eg.
Polyp, Meckels diverticulum
Hyperplasia of the Peyer’s patch in the terminal
ileum may be the initiating event
16.
17. Twisting or axial rotation of a portion of bowel
about its mesentery
Primary or secondary
10 – occurs secondary to congenital malrotation
of the gut, abnormal mesenteric
attachments, congenital bands
20 – rotation of a piece of bowel around an
acquired adhesion or stoma