What is it?
As the name suggests, intestinal obstruction is blockage of intestinal passage of food contents in varying stages of digestion. Intestinal obstruction can result in the classic symptoms of abdominal cramping, constipation (with or without obstipation depending on the severity of obstruction), emesis and abdominal distension. Often, the first imaging test performed is the simple abdominal radiograph which can demonstrate dilated fluid filled small bowel loops (we typically cannot see fluid filled loops so we say relative paucity of bowel gas which is a nonspecific finding) if the obstruction involves the lower intestinal tract.
Intestinal obstruction can be divided into two types based on location – upper and lower GI tract, that is, if the obstruction is before or after the level of the proximal jejunum (1).
Upper GI tract or “high” (congenital and acquired) obstructions include esophageal atresia, pyloric stenosis (gastric outlet obstruction), duodenal atresia, duodenal web, annular pancreas, and midgut volvulus. We will focus on pyloric stenosis, duodenal atresia/web, and midgut volvulus.
Lower GI tract or “low” obstructions can be further divided on the basis of age. Neonatal (birth to 28 days) include ileal and colonic atresia, anorectal malformation, meconium ileus, colonic dysmotility syndromes, and Hirschprung’s disease.
Ileocolic intussusception is the most important clinical entity in the infant and slightly older child (6 – 36 months) (90% of all intussusceptions) and is the most common surgical emergency in the lower intestinal tract of an infant.
Click on the links below to navigate to each type/subtype: