Mechanical or paralysing intestinal obstruction
Two different types of intestinal obstruction can be distinguished: The mechanical bowel obstruction and the debilitating bowel obstruction. In mechanical bowel obstruction, the involuntary bowel movement (so-called peristalsis), which transports the digested food remains towards the rectum, still takes place. However, this movement is severely restricted by obstacles in the intestine and the food cannot be transported further.
With regard to these obstacles, we speak of obturations if they are located inside the intestine, such as foreign bodies, worms or large gallstones. Obstructions are when the obstacle to bowel movement is outside the bowel itself, such as when a tumour proliferating in the abdominal cavity reduces the diameter of the bowel from the outside. In the worst case, a mechanical intestinal obstruction can be caused by a so-called strangulation, which means an interruption or even a complete lack of blood supply.
This is the most severe variant of mechanical ileus, as in this case the part of the intestine no longer supplied with blood can die completely within a few hours. This can be caused by intussusception or abdominal wall hernias (so-called hernias, including the well-known “inguinal hernia“). The paralyzing (so-called paralytic) intestinal obstruction is present when there is a complete interruption of intestinal movement.
In the paralytic intestinal obstruction, the interior of the intestine is still continuous, but movement simply stops. The causes of this can be varied and range from metabolic disorders (e.g. after kidney failure) to blunt abdominal injuries (as after a blow to the abdomen) to a so-called mesenteric infarction (obstruction of the artery that supplies the intestine with blood). The symptoms are often not clearly attributable to a mechanical or paralysing ileus.
In most cases, those affected suffer from severe, colicky cramps. These are painful contractions in which phases of severe pain alternate with brief periods of painlessness. An indication of an intestinal obstruction is also a distended abdominal wall and the absence of bowel movement.
Under certain circumstances, the symptoms can even lead to vomiting of the stool. Even intestinal obstruction in children is symptomatically not easy to detect, as children tend to complain of abdominal pain and discomfort with a wide variety of symptoms. In children, it also manifests itself through abdominal pain as well as paleness and cold sweat.
The child is very restless and anxious. The colicky pain is also typical here. A great difficulty for the child is that, depending on the development of the child‘s expressiveness, communicating and precisely describing the symptoms can vary greatly.
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