This document provides an overview of the general management of intestinal obstruction. It outlines the key steps in the algorithm including laboratory investigations like blood tests and imaging, supportive treatments like nasogastric aspiration and IV fluids, use of antibiotics and blood transfusions if needed, monitoring in the ICU, use of indwelling catheters, and clinical follow up to monitor for improvement or need for surgery. The goal of management is to reduce bowel distension, correct fluid and electrolyte losses, treat any infection, and determine if conservative treatment is sufficient or if surgery is required.

1. GENERAL MANAGEMENT
OF INTESTINAL OBSTRUCTION
- by ARINDAM ROY
8th semester

2. ALGORITHM FOR MANAGEMENT OF
A CASE OF INTESTINAL OBSTRUCTION

3. LABORATORY
INVESTIGATION
• COMPLETE BLOOD COUNT -
1. TLC
2. HAEMATOCRIT VALUE
• SERUM UREA AND CREATININE
• SERUM ELECTROLYTES
• LIVER FUNCTION TEST
• SERUM AMYLASE

4. SUPPORTIVE TREATMENT
1. Nasogastric AspirationS
• Non-vented Ryle’s tube
• Vented Salem tube

5. Role of nasogastric aspiration
• Reduce bowel distension
• Improve pulmonary ventilation
• Reduce risk of subsequent aspiration during
induction of anesthesia and post extubation

6. 2. Fluid and electrolyte
replacement
• I.V. fluid - to correct the fluid loss
• Electrolyte solution - to make up electrolyte
deficiency mainly sodium loss
• Hartmann’s solution or normal saline used
• Volume required to be determined by clinical
hematological and biochemical criteria

7. 3. Parenteral antibiotics
• Broad spectrum antibiotics- Ampicillin,
Gentamycin, Metronidazole, Cephalosporins
• To correct bacterial infection
• Mandatory for all patients undergoing small
or large bowel resection

8. 4. Blood Transfusion
• FFP or platelet transfusions
• Often needed in critical patients

9. 5. ICU Critical Care
• For systemic management of complications
like ARDS, DIC, SIRS
• If hypotension- Dopamine/Dobutamine

10. 6. Indwelling Catheter
• Perurethral
• To collect and measure 24 hours urine output
• Intake and output chart is made

11. 7. CVP For Fluid And
Monitoring
• PCWP (pulmonary capillary wedge pressure)
monitoring
• Needed in haemodynamically unstable
patients

12. 8. Clinical Follow Up
IMPROVEMENT DETERIORATION
• Conservative treatment • Surgery indicated if no
is carried on. improvement occurs
with in 24-48 hours