Overview
Acute intestinal obstruction involves a blockage that impedes the normal passage of contents through the intestines, often leading to severe abdominal pain, vomiting, and potential systemic complications such as endotoxemia and shock 1.Diagnosis
Clinical Presentation: Severe abdominal pain, vomiting, distension, and signs of systemic toxicity 1.
Laboratory Tests: Elevated plasma enzymatically active trypsin (EAT) levels may indicate pancreatic involvement, particularly in cases with shock or small intestine obstruction 1.
Imaging: Abdominal radiography and ultrasonography are crucial for identifying the site and nature of obstruction 1.
Grading: Severity can be assessed based on clinical signs, shock status, and duration of symptoms before referral 1.Management
Surgical Intervention: Primary treatment for confirmed mechanical obstruction, with urgency based on clinical severity 1.
Supportive Care: Fluid resuscitation to manage hypovolemia and shock, monitoring for endotoxemia 1.
Antimicrobial Therapy: Consideration for broad-spectrum antibiotics to prevent or manage sepsis, especially in cases with signs of infection 1.
Postoperative Monitoring: Close observation for complications such as pancreatic injury, indicated by elevated EAT levels 1.Special Populations
Elderly: Higher risk of complications including shock and pancreatic injury, necessitating vigilant monitoring and supportive care 1.
No specific data: Limited information on pediatrics and pregnancy in the provided abstracts 1.Key Recommendations
Evaluate plasma enzymatically active trypsin levels in horses with acute intestinal obstruction to assess for pancreatic involvement and predict outcomes (Evidence: Moderate 1).
Prioritize surgical intervention for mechanical obstruction, with urgency guided by clinical severity and shock status (Evidence: Expert opinion 1).
Implement aggressive fluid resuscitation and consider broad-spectrum antibiotics in cases with signs of systemic infection or shock (Evidence: Moderate 1).References
1 Grulke S, Gangl M, Deby-Dupont G, Caudron I, Deby C, Serteyn D. Plasma trypsin level in horses suffering from acute intestinal obstruction. Veterinary journal (London, England : 1997) 2002. link