treatment for large bowel obstruction (LBO)•supportive management: IV fluids, gastrointestinal decompression; 75% require surgical intervention
•surgical correction of obstruction
•volvulus: ☆initial decompression with flexible sigmoidoscopy, operative reduction or sigmoid resection dependent on severity
•mechanical obstruction: ostomy alone(fecal diversion), colectomy with primary anastomosis or Hartmann procedure. May pursue stenting as bridging (follow with another intervention) or palliation gastrointestinalsurgery国試過去3回 Sep 23, 2020, 3:05 AM HirotoShishido
signs of complicated SBO(small bowel obstruction)changes in the character of the pain, fever, hemodynamic instability (hypotension, tachycardia), guarding, leukocytosis, and significant metabolic acidosis (low bicarbonate in this patient)
Delay in surgery (★urgent surgical exploration)may lead to perforation and significant risk of mortality.
