Small Bowel Obstruction ⚡Mnemonic⚡

Causes of Small Bowel Obstruction Mnemonic

Mnemonic: HOBBLING

H – Hernias: Inguinal, femoral, and other hernias trapping bowel.
O – Obstruction due to adhesions: From previous surgeries or infections.
B – Bulges: Abdominal wall bulges indicating a potential hernia.
B – Bowel ischemia: Reduced blood flow leading to obstruction.
L – Luminal obstructions: Foreign bodies, gallstones, or bezoars.
I – Inflammatory diseases: Crohn’s disease or other inflammatory conditions.
N – Neoplasms: Tumors within or compressing the small intestine.
G – Gastroenteritis: Severe cases can lead to temporary obstruction.

Warning Signs of Small Bowel Obstruction Mnemonic

Mnemonic: WARNING SIGNS

W – Worsening abdominal pain: Progressive and severe pain.
A – Abdominal distension: Swelling and bloating of the abdomen.
R – Rumbling bowel sounds: Increased or decreased bowel sounds.
N – Nausea and vomiting: Especially after eating.
I – Inability to pass gas or stool: Indicative of complete obstruction.
N – No appetite: Loss of desire to eat.
G – Gastrointestinal bleeding: Less common, but a serious sign.
S – Sudden onset: Acute symptoms indicating an emergency.
I – Irregular bowel movements: Changes in habits or consistency.
G – Guarding: Tensing of abdominal muscles due to pain.
N – Not feeling well overall: General malaise.
S – Severe dehydration: Resulting from vomiting and inability to eat.

Diagnostic Tests for Small Bowel Obstruction Mnemonic

Mnemonic: TEST DIAGNOSIS

T – X-ray (Abdominal): Initial imaging to check for air-fluid levels.
E – Endoscopy: To visualize and possibly relieve obstruction.
S – Serum electrolytes: Assess for electrolyte imbalances.
T – CT scan: Detailed images to locate obstruction and its cause.
D – Duodenal studies: Specific imaging for the upper small bowel.
I – Inflammatory markers: Check for underlying inflammation.
A – Abdominal ultrasound: Useful in certain cases to visualize the bowel.
G – Gastrografin study: A contrast study to assess bowel function.
N – Nuclear medicine studies: For specific diagnostic purposes.
O – Oral contrast imaging: To delineate the gastrointestinal tract.
S – Stool studies: To rule out infections and other complications.
I – Imaging review: Reassessment of all imaging findings.
S – Surgical consultation: If obstruction is suspected to be surgical.

Signs & Symptoms of Small Bowel Obstruction Mnemonic

Mnemonic: SYMPTOMATIC

S – Severe abdominal pain: Cramping and intermittent.
Y – Yellowing skin (jaundice): In rare cases with liver involvement.
M – Movement of bowel contents heard less: Reduced bowel sounds.
P – Palpable abdominal mass: Sometimes detectable on physical exam.
T – Tenderness in abdomen: Painful to touch.
O – Obvious discomfort: Agitation and inability to find a comfortable position.
M – Malnutrition signs: In chronic obstructions.
A – Altered bowel habits: Diarrhea or constipation.
T – Timely vomiting: Post-meal vomiting indicating obstruction.
I – Intestinal rumbling: Increased or decreased bowel sounds.
C – Change in stool character: Thin or absent stool.

Complications of Small Bowel Obstruction Mnemonic

Mnemonic: COMPLICATIONS

C – Choking of bowel: Strangulation leading to necrosis.
O – Osmotic imbalance: Electrolyte disturbances.
M – Malabsorption: Nutrients not being absorbed.
P – Peritonitis: Inflammation of the abdominal lining.
L – Leukocytosis: Elevated white blood cell count.
I – Intestinal perforation: A severe and life-threatening complication.
C – Chronic symptoms: Ongoing discomfort and nutritional issues.
A – Abscess formation: Especially with strangulated obstructions.
T – Tissue death: Necrosis of bowel tissue.
I – Infection risk: Increased risk due to compromised bowel.
O – Obstruction recurrence: Especially in non-surgically treated cases.
N – Nutritional deficiencies: Due to impaired absorption.
S – Septicemia: Blood infection, especially after perforation.

Risk Factors For Small Bowel Obstruction Mnemonic

Mnemonic: RISK FACTORS

R – Recent abdominal surgery: Leading to adhesions.
I – Intestinal disorders: Like Crohn’s disease.
S – Scar tissue: From previous surgeries or injuries.
K – Known hernias: Especially inguinal or abdominal.
F – Foreign bodies: Swallowed or inserted objects.
A – Age: Older adults are at higher risk.
C – Cancer: Tumors in or around the intestines.
T – Twisting of the bowel: Volvulus or intussusception.
O – Obesity: Increased risk of hernias and other complications.
R – Radiation therapy: Can lead to adhesions and strictures.
S – Strictures: Narrowing of the bowel lumen.

Surgical Interventions for Small Bowel Obstruction Mnemonic

Mnemonic: SURGICAL

S – Small bowel resection: Removal of the obstructed segment.
U – Untwisting volvulus: Correcting twisted bowel sections.
R – Resection of adhesions: Cutting fibrous bands causing obstruction.
G – Gastrostomy: In some cases, to relieve pressure.
I – Incision and drainage: For abscesses, if present.
C – Creation of a stoma: Temporary or permanent, for waste bypass.
A – Anastomosis: Reconnecting bowel segments post-resection.
L – Laparotomy: Open surgery to directly access the bowel.

Differential Diagnosis of Small Bowel Obstruction Mnemonic

Mnemonic: DIFFERENT

D – Diverticulitis: Inflammation of the diverticula in the intestine.
I – Irritable bowel syndrome (IBS): Can mimic obstruction symptoms.
F – Functional bowel disorders: Like chronic pseudo-obstruction.
F – Foreign body ingestion: Especially in children and psychiatric patients.
E – Endometriosis: Can cause external compression of the bowel.
R – Rectal cancer: Lower GI tumors can indirectly affect small bowel.
E – Enteritis: Inflammation of the small intestine.
N – Neurogenic disorders: Affecting bowel motility.
T – Tuberculosis: Abdominal TB can mimic obstruction symptoms.

Adverse Reactions to Small Bowel Obstruction Treatments Mnemonic

Mnemonic: ADVERSE

A – Anastomotic leakage: Post-surgical complication.
D – Dehydration: From vomiting and reduced fluid intake.
V – Venous thromboembolism: Risk increases with surgery and immobility.
E – Electrolyte imbalances: Due to vomiting and poor absorption.
R – Renal failure: Acute, secondary to severe dehydration.
S – Surgical site infection: A risk after any invasive procedure.
E – Edema: Intestinal edema post-surgery or from IV fluids.

Laboratory Findings In Small Bowel Obstruction Mnemonic

Mnemonic: LAB FINDINGS

L – Leukocytosis: Elevated white blood cell count.
A – Anemia: Possible if chronic obstruction leads to malnutrition.
B – Blood urea nitrogen (BUN): Elevated due to dehydration.
F – Fluid electrolyte imbalance: Common due to vomiting.
I – Increased amylase: If pancreatitis is a complication.
N – Neutrophilia: Elevated neutrophils in acute obstruction.
D – Decreased potassium: From vomiting.
I – Inflammatory markers: Elevated CRP and ESR.
N – Nitrogen imbalance: Due to protein malnutrition.
G – Glucose alterations: From altered intake and absorption.
S – Serum creatinine: Can rise due to kidney function compromise.

Predisposing Factors of Small Bowel Obstruction Mnemonic

Mnemonic: PREDISPOSE

P – Previous abdominal surgeries: Leading to adhesions.
R – Radiation therapy history: Can cause strictures and adhesions.
E – External hernias: Like inguinal or femoral hernias.
D – Diverticulitis: Inflammation leading to obstruction.
I – Intestinal neoplasms: Tumors causing blockage.
S – Strictures: Narrowing of the intestine, congenital or acquired.
P – Peritoneal dialysis: History can predispose to adhesions.
O – Older age: Increased risk with age.
S – Sedentary lifestyle: Can contribute to overall risk.
E – Endometriosis: Especially with bowel involvement.

Drug Interactions of Medications Used in Small Bowel Obstruction Mnemonic

Mnemonic: DRUG MIX

D – Diuretics: Can worsen dehydration.
R – Renal function-altering drugs: Need careful monitoring.
U – Ulcer medications: Interactions with pain management drugs.
G – Glucose-altering medications: Need adjustment in obstructed patients.
M – Morphine and other opioids: Can reduce bowel motility.
I – Immunosuppressants: Risk in post-surgical patients.
X – X-ray contrast agents: Interactions with kidney function.

Contraindications of Treatments in Small Bowel Obstruction Mnemonic

Mnemonic: CONTRAINDICATE

C – Coagulopathy: Increased bleeding risk during surgery.
O – Ongoing chemotherapy: May delay surgical interventions.
N – Non-corrected electrolyte imbalances: Need stabilization first.
T – Total bowel ischemia: Requires immediate surgical intervention.
R – Recent myocardial infarction: High anesthesia risk.
A – Advanced malignancy: Where surgery may not be beneficial.
I – Intestinal perforation: Needs immediate surgical correction.
N – Neutropenic patients: High infection risk with interventions.
D – Decompensated heart failure: High anesthesia and surgery risk.
I – Intractable vomiting: Might need stabilization before certain treatments.
C – Child-Pugh C cirrhosis: High risk for any surgical procedure.
A – Acute renal failure: Needs management before major procedures.
T – Thrombocytopenia: Increased bleeding risk during surgery.
E – Extreme frailty or poor performance status: Surgery may not be tolerated.

Indications of Surgical Treatment in Small Bowel Obstruction Mnemonic

Mnemonic: SURGICAL NEED

S – Strangulation suspected: Immediate surgery required.
U – Unresponsive to conservative management: When medical treatment fails.
R – Recurrent obstructions: Frequent episodes necessitating surgery.
G – Gangrene suspected: Indicative of bowel necrosis.
I – Incomplete obstruction not resolving: Partial obstruction not improving.
C – Complete bowel obstruction: No passage of gas or stool.
A – Abscess formation: Requires surgical drainage.
L – Long-standing obstruction: Chronic obstruction needing intervention.
N – Neoplasms causing obstruction: Tumors requiring resection.
E – External hernias causing obstruction: Like inguinal hernias.
E – Enterocutaneous fistula: Abnormal connection needing repair.
D – Distended abdomen with signs of peritonitis: Surgical emergency.

Clinical Features of Chronic Small Bowel Obstruction Mnemonic

Mnemonic: CHRONIC FEATURES

C – Constipation or irregular bowel movements: Long-term changes.
H – Hydration issues: Chronic dehydration due to fluid loss.
R – Recurring abdominal pain: Intermittent, colicky pain.
O – Ongoing nutritional deficiencies: From malabsorption.
N – Nausea: Persistent or recurrent.
I – Intestinal bloating: Chronic distension.
C – Cyclical vomiting: Especially after meals.
F – Fatigue: Due to malnutrition and chronic illness.
E – Electrolyte imbalances: Persistent issues.
A – Anorexia: Loss of appetite.
T – Tenderness in abdomen: On physical examination.
U – Unexplained weight loss: Due to poor nutrient absorption.
R – Recurrent hospital visits: For symptoms management.
E – Edema: From protein loss and nutritional deficiencies.
S – Stool changes: Thin, pencil-like stools or changes in frequency.

Risk Factors For Small Bowel Obstruction Mnemonic
Mnemonic: RISK FACTORS

R – Recent abdominal surgery: Leading to adhesions.
I – Intestinal disorders: Like Crohn’s disease.
S – Scar tissue: From previous surgeries or injuries.
K – Known hernias: Especially inguinal or abdominal.
F – Foreign bodies: Swallowed or inserted objects.
A – Age: Older adults are at higher risk.
C – Cancer: Tumors in or around the intestines.
T – Twisting of the bowel: Volvulus or intussusception.
O – Obesity: Increased risk of hernias and other complications.
R – Radiation therapy: Can lead to adhesions and strictures.
S – Strictures: Narrowing of the bowel lumen.

Drugs Used To Treat Small Bowel Obstruction Mnemonic
Mnemonic: TREATMENT DRUGS

T – Total parenteral nutrition (TPN): For nutritional support.
R – Rifaximin: Sometimes used for bacterial overgrowth.
E – Electrolyte solutions: To correct imbalances.
A – Analgesics: For pain management, typically non-opioid to avoid worsening motility issues.
T – Thromboprophylaxis: Anticoagulants to prevent venous thromboembolism.
M – Motility agents: In specific cases to improve bowel movement.
E – Erythromycin: As a prokinetic agent in certain situations.
N – Nausea medication: Antiemetics for symptom control.
T – Tranquilizers: For severe anxiety or agitation.
D – Diuretics: In case of fluid overload.
R – Rectal suppositories: For relief of constipation if partial obstruction.
U – Ursodiol: In case of gallstone-related obstruction.
G – Gastrointestinal decompression agents: Such as enemas or Gastrografin.
S – Steroids: For inflammation, particularly in Crohn’s disease-related obstruction.

What Should Be Avoided In Small Bowel Obstruction Mnemonic
Mnemonic: AVOID THESE

A – Alcohol: Can worsen dehydration and electrolyte imbalances.
V – Vigorous exercise: Could exacerbate the obstruction or pain.
O – Opioids: As they can decrease intestinal motility.
I – Inflammatory foods: Such as spicy or highly acidic foods.
D – Delay in seeking treatment: Prompt medical attention is crucial.
T – Tight clothing: Can increase abdominal discomfort.
H – Heavy lifting: May worsen any existing hernias or adhesions.
E – Excessive fluid intake: Especially if vomiting is present.
S – Smoking: Can impair healing and bowel function.
E – Enemas: Should be avoided unless specifically recommended by a doctor.

Side Effects of Treatments for Small Bowel Obstruction Mnemonic
Mnemonic: SIDE EFFECTS

S – Surgical complications: Including infection, bleeding, or hernia.
I – Immunosuppression: From certain medications used in treatment.
D – Dehydration: Due to vomiting and reduced oral intake.
E – Electrolyte imbalances: Especially potassium and sodium imbalances.
F – Fatigue: From the illness itself and its treatment.
E – Edema: From intravenous fluids or nutritional imbalances.
C – Constipation: Particularly from opioid pain relievers.
T – Thrombosis: Risk of blood clots, particularly post-surgery.
S – Scar formation: Post-surgical internal and external scarring.