bkdaniels
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Apr 12, 2005, 3:17 AM
Post #2 of 7
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Hey stacy, how are you doing?
Bowel obstruction frequently
necessitates surgical intervention. However, antibiotics should be
started in the Emergency Department.
NOTE: Antibiotic coverage
must include gram-negative aerobic and gram-negative anaerobic
organisms. Therapy must cover all likely pathogens in the context of
this clinical setting:
(The following antibiotics do not represent
an all-inclusive list.)
Clindamycin (Cleocin)
Metronidazole
(Flagyl)
Aztreonam (Azactam)
Cefoxitin (Mefoxin)
Cefotetan
(Cefotan)
Imipenem and cilastatin (Primaxin)
Meropenem (Merrem)
Anyone suspected of having an intestinal obstruction is hospitalized.
The basic objective of treatment are to reopen the passageway as soon
as possible, either by decompression (preferred) or surgery, to
replace the fluid and nutrient losses intravenously (requires extreme
care and expertise; a mistake can do great harm), and to relieve pain.
Decompression is accomplished by means of suction. A long tube is
inserted into the intestine, and through suction, the obstruction is
often relieved.
If total obstruction lasts more than 24 hours and
concervative (non-sergical) theraphy is not successful, immediate
surgery is always indicated when the physician is convinced that total
strangulation, or infraction (blockage of the blood vessel in the
area, causing death of local tissue), has occured. In intussusception,
the patient is often given a barium enema for X-ray.
If this is
done early, before the disease has progressed too far, the enema
itself can often undo the partial obstruction. If the enema is given
too late, just the opposite can occur -- from partial blockage to
total strangulation.
In paralytic ileus, a result of previous
abdominal surgery or some other exterior derivation, an attempt is
made to stimulate bowel motility (peristalsis) by locally applied heat
(hot damp towels or electric pad) or certain drugs. It often does the
trick.
Best wishes,
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