When obstructing mechanism occludes mesenteric blood supply on wall of lumen. Necrosis occurs in 3 to 4 hours. Difficult to diagnose preoperatively. Small Bowel Obstruction Clinical manifestations. Cramping abdominal pain.
Continuous pain is suggestive of strangulation.
Earlier in high obstruction. Feculent vomiting, caused by bacterial overgrowth, may be seen especially with distal obstruction. More in lower obstruction. High-pitched bowel sounds. Secondary electrolyte abnormalities.