Etiology

Small bowel obstruction (SBO) accounts for 20 percent of all acute surgical admissions and results in approximately 9000 deaths per year in the United States. Less commonly, the intestine is obstructed at the large bowel.

Both large and small intestines may be obstructed by various pathologic processes (Iab!e...Z.ยง.-1). Extrinsic, intrinsic, or intraluminal processes precipitate mechanical obstruction. Differentiating SBO from large bowel obstruction (LBO) is important because the incidence, clinical presentation, and modes of therapy vary depending on the anatomic site of the obstruction. Ihe small intestine is characterized by transverse linear densities that extend completely across the bowel lumen (plicae circulares). Ihe colon is situated peripherally in the abdomen, is larger in diameter, and contains short, blunt, and thick projections (haustrae) that arise from the bowel wall and extend only partially into the lumen. Haustrae are less numerous and situated farther apart than plicae circulares.

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