Clinical Features
- Similar to distal large bowel obstruction
- Colic/nausea/vomiting/constipation/diarrhoea/fever (all common)
- Gross abdominal distension and peritonism
- Bowel sounds can be hypo or hyperactive
- Guarding and rebound tenderness (right iliac fossa) indicates peritonitis
- Patient already hospitalised e.g.
- Concomitant medical illness
- Previous surgery or Caesarean section
- Recovering from pelvic, spinal or retroperitoneal trauma
- Can come on over 2-3 days
- Aged 60-70
- Raised white cell count +/- fever suggests peritonitis
