Typical clinical features

• severe colicky epigastric and periumbilical (mainly) pain (Fig 30.11)

• spasms last about 1 minute

• spasms every 3-10 minutes (according to level)

• absolute constipation (nil after bowel emptied)

• abdominal distension (especially if lower SBO)

colicky central pair» vomiticig distension

checi;

umbilicus and hernia orifices checi;

umbilicus and hernia orifices

Fig. 30.11 Typical pain distribution of small bowel obstruction

Dealing With Back Pain

Dealing With Back Pain

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