Introduction
An acute intestinal obstruction is an emergency situation. The intestinal obstruction is often accompanied by severe abdominal cramps and vomiting. Those affected have no bowel movement or very thin bowel movements.
In many cases an intestinal disease is already known beforehand. These include tumour diseases, chronic inflammatory diseases and genetic diseases. A diagnosis is possible with the help of X-rays, CT and MRI images and ultrasound examinations.
Methods of detection
The first suspected diagnosis of intestinal obstruction is in most cases a clinical diagnosis. This means that the overall picture of the affected person indicates intestinal obstruction. This includes the corresponding medical history, the lack of or thin bowel movements and severe pain accompanied by vomiting.
At the beginning of the examination, the doctor can listen to the abdomen with a stethoscope. In the case of a mechanical closure, there is often a lot to hear in front of the closure site and hardly anything afterwards. With a paralyzed intestine, no digestive sounds are heard.
The first technical possibility to confirm the diagnosis is ultrasound. This is a quickly available examination technique that does not have any side effects. The ultrasound can reveal both the obstruction and the accumulated food pulp.
In further examinations like the MRT a more precise image is possible. However, this is often no longer necessary if previous images already show the intestinal obstruction. The intestinal obstruction can also be visible in X-rays.
Besides these technical possibilities, blood values are an indicator. The ultrasound examination is a quickly available examination without side effects. The examiner applies gel to the abdomen and presses the ultrasound probe onto the skin.
Water appears black in the ultrasound image, while air appears rather white. Normally the intestine is difficult to examine in the ultrasound because it is filled with air and overlaps in many places. However, in the case of an intestinal obstruction, food pulp accumulates and the intestinal loops are clearly visible.
Many doctors’ surgeries have an ultrasound machine in their offices. The abdomen X-ray is an overview of all abdominal organs. This x-ray is usually taken once while lying down and once while standing to detect any changes.
This reveals over-inflated intestinal loops. In addition, the patient can be given a contrast medium. This causes the contrast medium to be retained at the site of occlusion, thus allowing localisation.
Disadvantages of X-rays are the radiation exposure and possible intolerance to the contrast medium. Computer tomography works exactly like an X-ray machine with radiation. However, the images are much more precise.
Especially in combination with a contrast medium, CT can often even reveal the exact cause of the intestinal obstruction. For the examination, the patient is placed on a couch and drives into a tube, where he or she must lie as still as possible. However, computed tomography is only performed in acute suspected cases, as the radiation exposure is much higher than with X-rays.
CT equipment is normally only available in hospitals and radiological practices. A magnetic resonance tomography is another technical possibility to diagnose intestinal obstruction. Especially for soft tissue such as the intestine, MRI is well suited.
Here, too, the affected person drives into a tube and must lie still. An MRI does not involve radiation exposure and is therefore gentler on the body. Especially with children, this is preferred to CT in order to reduce radiation exposure.
Metal objects, such as piercings, must be removed beforehand, as the MRI works with magnets. An MRT is also only available in hospitals and radiological practices. Learn more about this under: MRIThe blood count can be changed in various places, but it need not always be conspicuous.
If inflammation is the cause of intestinal obstruction, some inflammatory parameters, such as CRP and leukocytes, may be elevated. This is especially to be expected after a breakthrough with beginning peritonitis. The electrolytes, i.e. the salt balance, can also shift because the intestine is no longer able to absorb enough water and electrolytes. Often the blood test also serves to exclude other diseases.
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