A 92 yo F patient presents to the ED with constipation, bilious vomiting, and intractable abdominal pain. An acute abdominal series suggests she has a small bowel obstruction, but can’t rule out the possibility that there is an infarction of some of the bowel. She’s acutely dehydrated, and appears poorly fed. IV fluids are started. Upon admission to the floor, she demonstrates somatic dysfunction at the B/L temporo-occipital suture, from T8-L2, and also along a line from the umbilicus to the solar plexus. She is treated with soft-tissue OMT, including rib raising, upper lumbar paraspinal inhibition, release of the celiac, superior and inferior mesenteric ganglia, and V-spread, and she defecates voluminously within hours. the next day the treatment is repeated twice, with the same results. The following day she is not treated in the morning, and produces no stool, but receives treatment in the afternoon and defecates again. In the mean time she has a CT angiogram which indicates that she has a significant portion of infarcted small bowel. She begins to decompensate, has a palliative small bowel resection, and expires two days later, never having regained consciousness after bowel surgery.
outcomes in patients who develop postoperative ileus: A retrospective chart review. International Journal of Osteopathic Medicine 12 (2009) 32-37.
Techniques: Pedal Pump, Myofascial release to chest wall and upper thoracic region
Techniques: HVLA of the cervical and thoracic spine
Techniques: Thoracic Lymphatic Pump, ME for ribs
1. Which of the following statements are true regarding gastrointestinal motility:
3. Identify the most likely pairing of vertebral level and somatic dysfunction in a patient presenting with an ileus in the region of the duodenal-jejeunal junction:
4. In which of the following areas is an examiner most likely to find somatic dysfunction in an acute appendicitis?