Abdominal colic is a disorder in the normal flow of intestinal contents along the intestinal tract. Obstruction occurs when there are problems which cause obstruction of the flow of intestinal contents into the future but peristaltiknya normal. Many are also experts who define click the abdomen as a condition characterized by severe cramping or colicky pain, which may be accompanied by nausea and vomiting.Abdomen Colic etiology
1. MechanicalAdhesion / postoperative adhesions (90% of mechanical obstruction)
• Carcinoma
• volvulus
• Intussusception
• obstipasi
• Polyps
• Stricture
2. Functional (non-mechanics)
• paralytic ileus
• spinal cord lesions
• regional enteritis
• electrolyte imbalance
• UremiaClinical manifestations Abdomen Colic
1. Simple mechanics - the small intestine ofColic (cramps) in the mid to upper abdomen, distension, vomiting bile early, increased bowel sounds (high pitched tinkling sounds at short intervals), minimal diffuse tenderness.
2. Simple mechanics - small intestine underColic (cramps) midabdomen significant, severe distension, vomiting - is little or no - and then have the dregs, bowel sounds and the sound of "hush" to increase, minimal diffuse tenderness.
3. Simple mechanics - colonCramps (abdominal middle to bottom), which emerged last distension, and vomiting (fekulen), increased bowel sounds, diffuse tenderness at a minimum.
4. Partial mechanical obstructionCan occur with granulomatous bowel in Crohn's disease. Symptoms cramping abdominal pain, mild distention and diarrhea.
• Carcinoma
• volvulus
• Intussusception
• obstipasi
• Polyps
• Stricture
2. Functional (non-mechanics)
• paralytic ileus
• spinal cord lesions
• regional enteritis
• electrolyte imbalance
• UremiaClinical manifestations Abdomen Colic
1. Simple mechanics - the small intestine ofColic (cramps) in the mid to upper abdomen, distension, vomiting bile early, increased bowel sounds (high pitched tinkling sounds at short intervals), minimal diffuse tenderness.
2. Simple mechanics - small intestine underColic (cramps) midabdomen significant, severe distension, vomiting - is little or no - and then have the dregs, bowel sounds and the sound of "hush" to increase, minimal diffuse tenderness.
3. Simple mechanics - colonCramps (abdominal middle to bottom), which emerged last distension, and vomiting (fekulen), increased bowel sounds, diffuse tenderness at a minimum.
4. Partial mechanical obstructionCan occur with granulomatous bowel in Crohn's disease. Symptoms cramping abdominal pain, mild distention and diarrhea.
5. DisturbanceSymptoms develop rapidly; severe pain, continuous and localized; distension medium; persistent vomiting, decreased bowel sounds usually dn severe localized tenderness. Stool or vomitus into dark-colored or bloody or blood containing vague.Examination
• tension, pulse, respiration, temperature
• Abdominal examination: location of pain, is there any tenderness / pain free? Is there a liver enlargement, whether palpable masses?
• Rectal examination: location of pain at the time, is there any faeces, is there blood?
• Laboratory: Leukocytes and HbExamination Support
1. X-ray abdomen showed gas or fluid in the intestine
2. Barium enema showed a terdistensi colon, filled with air or sigmoid folds are closed.
3. Decrease in serum levels of sodium, potassium and chloride from vomiting; increased count SDP with necrosis, strangulation or peritonitis and elevated levels of serum amylase because of irritation of the pancreas by the folds of the intestine.
4. Arterial blood gases may indicate metabolic acidosis or alkalosis.Medical Treatment
• Correction fluid and electrolyte imbalance
• Treatment of Na +, K +, blood components
• Ringer lactate to correct the lack of interstitial fluid
• Dextrose and water to correct deficiencies intracellular fluid
• Decompression nasoenteral a long hose from the proximal intestine to the area of blockage, the hose could be incorporated more effectively with the patient lying on his side to the right.
• Implement fatherly treatment of shock and peritonitis.
• hyperalimentation to correct protein deficiency due to chronic obstruction, paralytic ileus, or infection.
• bowel resection with end to end anastomosis.
• The double-barrel Ostomi if from end to end anastomosis was too risky.
• loop colostomy to divert the faecal stream and decompressing the intestine with bowel resection performed as a second procedure.Action
• Infusion RL; if anuria -> IV RL: D5 = 1:1
• When severe dehydration -> infusion washed down, placed the catheter dauwer
• Give a mild analgesic (xylomidon), spasmolytic: Baralgin, sulfas Aliopin (inj); if a lot of pain -> give petidin an amp im, do not give antibiotics if the cause is not clear
• If the patient restless restless, give diazepam 10 mg iv, may be repeated every 30 minutes
• When hot, put: antipyretics (paracetamol)
• When the general condition is poor, give supportive Vitamins / Alinamin F (inj), Cortison Dexamethasone inj 3 cc or 2 amp
• If the efforts above situation does not improve, refer to the Hospital Bibliography1. Nettina, Sandra M. Nursing Practice Guidelines. Translation Setiawan et al. Ed. 1. Jakarta: EGC; 20012. Suzanne C. Smeltzer Medical Surgical Nursing Textbook Brunner & Suddarth. Great translation Kes, et al. Editor Monica Esther, et al. Ed. 8. Jakarta: EGC; 2001.3. Tucker, Susan Martin et al. Patient Care Standards: Nursing Process, diagnosis, And Outcome. Yasmin translation compassion. Ed. 5. Jakarta: EGC; 19984. Price, Sylvia Anderson. Pathophysiology: Clinical Concepts Of Disease Processes. Translation Peter Grace. Ed. 4. Jakarta: EGC; 1994
• tension, pulse, respiration, temperature
• Abdominal examination: location of pain, is there any tenderness / pain free? Is there a liver enlargement, whether palpable masses?
• Rectal examination: location of pain at the time, is there any faeces, is there blood?
• Laboratory: Leukocytes and HbExamination Support
1. X-ray abdomen showed gas or fluid in the intestine
2. Barium enema showed a terdistensi colon, filled with air or sigmoid folds are closed.
3. Decrease in serum levels of sodium, potassium and chloride from vomiting; increased count SDP with necrosis, strangulation or peritonitis and elevated levels of serum amylase because of irritation of the pancreas by the folds of the intestine.
4. Arterial blood gases may indicate metabolic acidosis or alkalosis.Medical Treatment
• Correction fluid and electrolyte imbalance
• Treatment of Na +, K +, blood components
• Ringer lactate to correct the lack of interstitial fluid
• Dextrose and water to correct deficiencies intracellular fluid
• Decompression nasoenteral a long hose from the proximal intestine to the area of blockage, the hose could be incorporated more effectively with the patient lying on his side to the right.
• Implement fatherly treatment of shock and peritonitis.
• hyperalimentation to correct protein deficiency due to chronic obstruction, paralytic ileus, or infection.
• bowel resection with end to end anastomosis.
• The double-barrel Ostomi if from end to end anastomosis was too risky.
• loop colostomy to divert the faecal stream and decompressing the intestine with bowel resection performed as a second procedure.Action
• Infusion RL; if anuria -> IV RL: D5 = 1:1
• When severe dehydration -> infusion washed down, placed the catheter dauwer
• Give a mild analgesic (xylomidon), spasmolytic: Baralgin, sulfas Aliopin (inj); if a lot of pain -> give petidin an amp im, do not give antibiotics if the cause is not clear
• If the patient restless restless, give diazepam 10 mg iv, may be repeated every 30 minutes
• When hot, put: antipyretics (paracetamol)
• When the general condition is poor, give supportive Vitamins / Alinamin F (inj), Cortison Dexamethasone inj 3 cc or 2 amp
• If the efforts above situation does not improve, refer to the Hospital Bibliography1. Nettina, Sandra M. Nursing Practice Guidelines. Translation Setiawan et al. Ed. 1. Jakarta: EGC; 20012. Suzanne C. Smeltzer Medical Surgical Nursing Textbook Brunner & Suddarth. Great translation Kes, et al. Editor Monica Esther, et al. Ed. 8. Jakarta: EGC; 2001.3. Tucker, Susan Martin et al. Patient Care Standards: Nursing Process, diagnosis, And Outcome. Yasmin translation compassion. Ed. 5. Jakarta: EGC; 19984. Price, Sylvia Anderson. Pathophysiology: Clinical Concepts Of Disease Processes. Translation Peter Grace. Ed. 4. Jakarta: EGC; 1994
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