Hi, this is Tom, and in this episode I'm going to be going through intestinal obstruction

in children. And you can find notes at zero to finals.com and in the zero to finals pediatrics book.

And you can find flashcards and questions at members.0.0.0.com. And at the end of the

episode, we'll go through some questions so you can test yourself on what you just heard. So let's

jump straight in. Intestinal obstruction is where the passage of food, fluids and gas through the

intestines becomes blocked.

Small bowel obstruction is more common than large bowel obstruction.

The obstruction results in a build-up of gas and fecal matter proximal or before the obstruction, causing dilation of the proximal bowel and vomiting.

It also causes absolute constipation, whether patient is unable to pass stools or wind.

Children with partial obstruction may still pass small amounts of stool.

Let's go through the causes.

The top causes of bowel obstruction in children are interception,

Hirshsprung's disease,

meconium ileus,

which is usually caused by cystic fibrosis, adhesions, for example, due to previous

intra-abdominal surgery or intraminal inflammation, volvulus caused by congenital malrotation of the intestines, and an incarcerated hernia,

for example an ingranal hernia.

Adesians are pieces of scar tissue that bind the abdominal contents together.

They can cause kinking or squeezing of the bowel leading to obstruction.

Adesians typically cause obstruction in the small bowel rather than the large bowel.

They're most often caused by previous abdominal surgery or intra-abdominal inflammation,

for example from appendicitis or peritonitis.

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