Home / Rx Protocol / Surgery / General Surgery

Intestinal Obstruction

Protocols

Clinical Features:

  • 1)Crampy abdominal pain that comes and goes.
  • 2)Loss of appetite.
  • 3)Constipation.
  • 4)Vomiting.
  • 5)Inability to have a bowel movement or pass gas.
  • 6)Swelling of the abdomen.


O/E:

  • 1)Abdominal rigidity 
  • 2)Bowel sound absent or increase 

Investigations:

  • 1)CBC
  • 2)Plan X-ray abdomen in errect posture
  • 3)usg of W/A 
  • 4)Serum electrolyte 


Rx:
  • Bed rest
  • Diet: NPO TFO
  • NG Suction - 2 hourly
  • Continuous Catheterization

1. Inf Hartsol ([post id="506" title="Hartmann"]) (2L)+5% DNS (1L)

  • I/V@30 d/min

2. Inj. Ceftron([post id="398" title="Ceftriaxone"]) (1gm)

  • 1 vial ...I/V..... BD

3. Inj. Filmet([post id="406" title="Metronidazole"]) (500mg/100ml)

  • 1 bag/bottle... I/V .......TDS

4. Inj. Maxpro([post id="392" title="Esomeprazole"]) (40mg)

  • 1 vial ........I/V ..........BD

5.Inj. Torax ([post id="450" title="Ketorolac"])(30mg)

  • 1amp 1/M   ........stat& sos

if Severe pain

Inj.Nalbun-2([post id="457" title="Nalbuphine"])

1 ample .I/M .......stat

+(plus)

Inj. Vergon([post id="505" title="Prochlorperazine"] (12.5mg)

  •  1 amp I/M- stat & sos

If Vomiting

Inj.Emistat([post id="509" title="ondansetron"])

  • 1 ample I/V stat  & sos

 

6. Monitor vitals sign

7.Follow-up 

 

Advice:

  • Try to eat smaller amounts of food more often.
  • Chew your food very well.
  • Avoid high-fibre foods and raw vegetables and fruits with skins, husks, strings, or seeds.
  • Check with your doctor before you eat whole grain foods or use a fibre supplement such as Benefibre or Metamucil.


❣️❣️বিখ্যাত হওয়ার প্রথম পদক্ষেপ হচ্ছে বিশ্বাসী হওয়া-ওয়ান্ট হুইটম্যান।❣️❣️



 Discharge Treatment:

1.Cap.Denver([post id="399" title="Cefixime"]) (200mg)

  • 1+0+1……...7 days

2. Tab.Fimet ([post id="406" title="Metronidazole"]) (400mg)

  • 1+1+1………..5 days

3.Cap.sergel ([post id="392" title="Esomeprazole"]) (20mg)

  • 1+0+1………..14 days

4.Tab.Rolac([post id="450" title="Ketorolac"])  (10mg)

  • 1+0+1(after meal) ….5 days

5.Tab.Rivotril([post id="474" title="Clonazepam"]) (0.5mg)

  • 0+0+1……..15 days

6.Tab.CEEVIT([post id="466" title="Ascorbic"] Acid)(250mg)

  • 1+0+1……...10 days

7.Tab.Xinc-OT([post id="470" title="Zinc"])

  • 1+0+1…………1 month


 

Advice:

  • Try to eat smaller amounts of food more often.
  • Chew your food very well.
  • Avoid high-fibre foods and raw vegetables and fruits with skins, husks, strings, or seeds.
  • Check with your doctor before you eat whole grain foods or use a fibre supplement such as Benefibre or Metamucil.


❣️❣️বিখ্যাত হওয়ার প্রথম পদক্ষেপ হচ্ছে বিশ্বাসী হওয়া-ওয়ান্ট হুইটম্যান।❣️❣️


https://accounts.google.com/b/0/AddMailServicehttps://accounts.google.com/b/0/AddMailService

Pre-Operative Order:


1.Diet: NPO ,TFO

2. Inf. Hartman solution ([post id="506" title="Hartmann"])(1000ml)

  • ……10-20 drop/min


3.Inj.Ceftron([post id="398" title="Ceftriaxone"]) (1gm)

  • … 1 vial I/V ….stat


4. Inj.Sergel ([post id="392" title="Esomeprazole"])(40mg)

  • …1 vial I/V stat


5.Inj.Rolac([post id="450" title="Ketorolac"]) (30mg)

  • ….1 ample I/M OR I/V stat & SOS

6.Clean the operative area .


7.send the patient OT table 30 min before operation .


8. Counsel the patient party & written consent must be taken.

Post Operative Order:


1.Diet: NPO, TFO(Till further order)

2.Inf.Hartman ([post id="506" title="Hartmann"])(1L) +

Inf.5%DNS([post id="510" title="DNS"])(1L) +

Inf.5%DA ([post id="511" title="Dextrose "])(1L)

  • ….I/V 30 drop/min.


3. Inj.Ceftron([post id="398" title="Ceftriaxone"])  (1gm)

  • … 1 vial I/V ….BD 


4. Inj.Sergel ([post id="392" title="Esomeprazole"])((40mg)

  • …1 vial I/V ….BD


5.Inj.Filmet([post id="406" title="Metronidazole"])(500mg/100ml)

  • …1 bottle I/V….stat.& TDS


6.Inj.Rolac([post id="450" title="Ketorolac"]) (30mg)

  • ….1 ample I/M OR I/V stat & TDS 

OR 

Inj.Anadol([post id="453" title="Tramadol"]) (100mg/2ml)

  • ….1 ample I/M OR I/V stat & TDS



7.Nalbun-2( Nalbuphine)

  • …1 ample I/M stat 

OR 

Inj.G-Pethidine([post id="456" title="Pethidine"](100mg/2ml)

  • …..1 ample I/M stat

With 

Inj.Vergon(Vergon) (12.5mg/ml)

  • …1 ample …I/M stat 


8.Voltaline ([post id="448" title="Diclofenac"])suppository (50mg)

  • ….1 stick Per rectal –SOS


9.Monitor all Vitals…any abnormality then call doctor