Bowel obstruction classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

## Overview

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Bowel obstruction may be classified by 5 different classification methods including: Open and closed, incomplete and complete, extrinsic, intrinsic and intraluminal, true and pseudo-obstruction, and finally, small bowel and large bowel. In this chapter, the extrinsic, intrinsic and intraluminal classification method will be used.

## Classification

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Bowel obstruction may be classified as follows:[1][2]

* Open or closed bowel
* Open type of bowel obstruction refers to an obstruction at a single location where the rest of the bowel is patent. A closed bowel obstruction refers to an obstruction occurring at two locations, so that there is no proximal or distal outlet.
* Complete or incomplete obstruction
* Obstructions can either completely occlude the lumen of the bowel, or can partially (incompletely) occlude the bowel.
* Extrinsic, intrinsic/intramural or intraluminal obstruction
* An obstruction may be due to an external cause, for example, a tumor that pushes on the bowel from the outside.
* An obstruction may be caused by an intrinsic (intramural) wall abnormality, for example, a tumor or stricture or hematoma.
* An intraluminal obstruction describes the process by which a luminal defect prevents the normal passage of bowel contents, for example, a foreign body, gallstone or an intussusception.
* Small or large bowel obstruction
* Small bowel obstruction include obstructions that occur along the duodenum up to the ileocecal junction, obstructions beyond this junction are classified as large bowel obstructions. A subset of large bowel obstruction includes outlet obstructions.
* True or pseudo-obstruction
* Ogilvie's syndrome and adynamic (paralytic) ileus represent pseudo-obstructions, and are not true mechanical obstructions as the bowel is dilated and patent but intestinal contents are not able to pass.

Bowel obstruction classification algorithm:

| Bowel obstruction classification|

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Open or Closed|

| Large bowel or Small bowel|

| Extrinsic or Intrinsic or Intraluminal|

| Complete or Incomplete|

| True or Pseudo obstruction|

| Outlet obstruction (a subset of large bowel obstruction)|

## References

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1. ↑ Mucha P (1987). "Small intestinal obstruction". Surg. Clin. North Am. 67 (3): 597–620. PMID 3296252.
2. ↑ Miller G, Boman J, Shrier I, Gordon PH (2000). "Natural history of patients with adhesive small bowel obstruction". Br J Surg. 87 (9): 1240–7. doi:10.1046/j.1365-2168.2000.01530.x. PMID 10971435.

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