8.1.2  Intestinal obstruction

Intestinal obstruction means a blockage somewhere in the gastrointestinal system (look back at Figure 8.1) and is another important cause of acute abdominal pain. It can be caused by either mechanical or non-mechanical obstructions. A mechanical obstruction means that something is physically blocking the digestive tract, preventing the flow of food through the intestine.In the case of non-mechanical obstruction, the digestive tract is not directly blocked, but food does not move forwards because of some problem in the muscular action of the intestine itself, which normally pushes the food along. Without special tests, it is difficult to diagnose whether a blockage is mechanical or non-mechanical. In both cases, the patient will require immediate referral to a higher health facility.

The signs and symptoms of intestinal obstruction are:

• Abdominal pain, which may be throughout the abdomen
• Nausea and vomiting
• Constipation (absence of gas and faeces)
• Abdominal distension (swollen abdomen)
• Tenderness and rigidity of the abdominal muscles guarding the internal organs
• Shock (in advanced cases).

The pre-referral actions described above for acute appendicitis also apply to a patient with suspected intestinal obstruction.