Speculum - University of Melbourne

24 SPECULUM
8. Special tests:
enemata—queried
radiograph of abdomen
fluid levels
bowel distension.
Differential diagnosis includes many
medical conditions, and surgical conditions
such as other abdominal colics, acute cholecystitis,
.and pancreatitis. To assist in
differential diagnosis the causes of intestinal
obstruction can be considered in age
groups.
1. Congenital—failed perforation of developmental
septum.
2. Two weeks—pyloric stenosis.
3. Nine months—intussusception.
4. Two to three years—Hirschsprung's.
5. 15-20 years—tuberculous adhesions.
6. 35 years—post-operative adhesions.
7. 45-50 years—strangulated hernia.
8. 50 years—carcinoma of colon.
9. Rarer
in the lumen,
in the wall,
outside the wall.
Treatment
can be summarised as:
1. of the cause,
2. of the peritonitis,
3. of the ileus.
Jenny kissed me where I sat,
Jumping from the chair she sat in,
Time, you thief, who love to put
Sweets in your list—put that in!
Say I'm feeble, say I'm old,
Say that health and wealth have missed me,
Add I've had a filthy cold
Since Jenny kissed me.
J.M.
Toll for the Brave,
The Brave that are no more!
All drunken and unshaved
As soon as they were ashore!
Eight hundred of the Brave,
No matter how they tried
Could not survive the little heel
Whom they had lain beside.
J.M.
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