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학습 자료 둘러보기 →In a suspected mechanical bowel obstruction, auscultate all four quadrants for at least 2 minutes before concluding bowel sounds are absent. Listen for high-pitched, tinkling sounds or borborygmi, which indicate hyperperistalsis proximal to the blockage.
These sounds are often described as "rushes" and may occur in bursts coinciding with cramping pain. As the obstruction progresses and the bowel fatigues, sounds may become hypoactive and eventually absent, a late and ominous sign.
Do not rely on a single auscultation. Serial assessments are critical to detect the transition from hyperactive to absent bowel sounds, signaling clinical deterioration. Absent sounds in a patient with distension and pain is a surgical emergency.
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