Microvascular changes in the bowel wall allow translocation to the mesenteric lymph nodes. This is associated with an increase in incidence of bacteremia, due to Escherichia coli , but the clinical significance is unclear. Mortality and morbidity depend on correctly diagnosing and characterizing the obstruction. Abdominal pain - is present with most patients. Colicky pain is more prevalent in simple obstruction.
Constant pain is more prevalent later in the course of strangulation.
Abdominal distention Duodenal or proximal small bowel have less distention when obstructed than if distal bowel when obstructed. Rule out incarcerated hernias of groin, femoral triangle, and obturator foramina. Check for masses, which suggest obturator hernia. Check for symptoms commonly thought to be more diagnostic of intestinal ischemia. No reliable way exists to differentiate simple from early-strangulated obstruction on physical examination.