Differentiating the location of bowel obstruction based upon history and symptoms

Symptoms	Gastric-proximal small bowel	Distal small bowel or large bowel
Vomiting	Bilious, watery, large volume, no or little odor	Particulate, small volume, foul smelling; may be absent
Pain	Early symptom; peri-umbilical, short, intermittent pain	Deep visceral; crampy; long intervals between cramps
Abdominal distension	Not necessarily present	Present
Anorexia	Always	Not necessarily present

Graphic 113423 Version 1.0

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