Chapter I INTRODUCTION

Intestinal obstruction is a significant mechanical impairment or complete arrest of the passage of contents through the intestine. Overall, the most common causes of mechanical obstruction are adhesions, hernias, and tumors. Other general causes are diverticulitis, foreign bodies (including gallstones), intussusceptions (bowel folding into itself), and volvulus (twisting of the colon). The symptoms usually include cramping pain, vomiting, constipation, and lack of flatus. Diagnosis is clinical which is confirmed by abdominal x-rays. Treatment is fluid resuscitation, nasogastric suction, and, in most cases, surgery. Intestinal obstructions account for 20% of all acute surgical admissions. Mortality and morbidity are dependent on the early recognition and correct diagnosis of obstruction. If untreated, strangulated obstructions cause death in 100% of patients. However, the mortality rate decreases to 8% with prompt surgical intervention (Vicky P. Kent, RN, PhD, CNE, 2009). In the course of this study, 84 year-old, Nanay Ganda, admitted last December 8, 2010 at General Santos Doctors Hospital under the care of Dr. Albano, had complaints of inability to defecate by about 4 days. A

background of one year history of intermittent abdominal pain with bloating was claimed by the patient. Because of this, Dr. Albano believed that the disorder had a gradual onset and its symptoms were experienced timely yet later with age. The patient recently claimed that pain usually starts at the right upper quadrant and radiates all throughout the abdomen. Abdominal distention was also observed with rounded asymmetric contour of the abdomen. The bowel sounds were normal at first and becomes quiet later on. She also had episodes of vomiting. Last December 13, 2010, the patient had undergone exploratory lap and the surgeon found out that there was a presence of tumor and immediately removed it. However, the result of the biopsy has not been seen. She also had a colostomy to eliminate waste products until such time the colon heals. The study focuses on the nature and possible causes which may lead people to experience this obstruction. The patient is in her older age and same with other elders who have the same case as Nanay Ganda, it is difficult in their parts to deal with the disorder. Since they are older, they need more attention and care from the medical team, and particularly, from their significant others. It is for this reason why the student nurses decided to have the case. To give awareness and knowledge of whats the disorder all about and how can somebody be of help to manage patients with this case especially the older ones.

This will be a big implication in the medical and nursing care since it is a challenge to diagnose a bowel obstruction. The keys to successful management are to identify signs and symptoms that may present very subtly at first, followed by a commitment to help the patient before the condition becomes aggravated. Whatever the treatment, participation in management and postoperative care is vital. Staying current with new findings and methods is the best course.