Patient's Risk factors for Small Bower Obstruction

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Mr. Cauthen is at risk of small intestinal obstruction due to appendicitis inflammation and adhesion-related blockage associated with the treatment. Although the risk is low, acute appendicitis is a pathologic lead point in small intestinal obstruction, affecting the structural normality of the gut wall. Adhesion is also caused by periappendicular inflammation, resulting in mechanical blockage of the gut. The pathogenesis can take several forms, with the most frequent being an inflammatory tip sticking to the posterior peritoneum, causing intestinal compression. The inflamed tip can also form a loop through which herniation occurs, causing strangulation or obstruction. The inflamed appendix can also cling to the mesentery near the ileocolic artery, with the undersupply of blood leading to gangrenous development at the terminal ileum (Harrison, Mahawar, Brown, Boobis & Small, 2009).

Mr. Cauthen can also experience small bowel obstruction once the acute appendicitis is treated. Surgery is the treatment of choice, with both open operation and laparoscopic appendectomy remaining popular for a different set of benefits. However, the procedure is associated with postoperative adhesion like other abdominal procedures such as colorectal surgery. The development exposes individuals to post-appendectomy small bowel obstruction. The susceptibility is a well-explored issue, with studies suggesting that the risk is 5-15% among operations in complicated appendicitis (Ziegler, Azizkhan, von Allmen, & Weber, 2014, p.629). The risk is even greater when the patient is not placed under conservative management, where post-operative interventions such as fluid replacement and nasogastric suction reduce the risk of adverse events. The surgical treatment of appendicitis can also cause a hernia, with the strangulation cause mechanical blockage.


Harrison, S., Mahawar, K., Brown, D., Boobis, L., & Small, P. (2009). Acute appendicitis presenting as small bowel obstruction: two case reports. Cases Journal, 2(1), 9106.

Ziegler, M., Azizkhan, R. G., von Allmen, D., & Weber, T. (2014). Operative pediatric surgery. McGraw-Hill Professional.

May 24, 2023

Learning Management

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Case Study Patient Risk

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