What are key findings in the physical exam for small bowel obstruction?

In cases of small bowel obstruction, the key findings during a physical examination typically include abdominal tenderness, guarding, and abnormal bowel sounds. The tenderness arises from the accumulation of fluid and gas within the obstructed section of the bowel, leading to distension and potential irritation of the peritoneum. Guarding is a reflexive response to pain where the abdominal muscles tense up to protect the area, further indicating the presence of an underlying pathological condition. Abnormal bowel sounds, including potentially increased or tinkling sounds, can signify heightened peristalsis as the bowel attempts to move contents past the obstruction.

These clinical signs encompass the typical presentation seen during a physical examination of a patient suspected of having a small bowel obstruction, helping to guide further diagnostic interventions and management.