A small bowel obstruction (SBO) is no small deal. And a SBO is reportedly what led to the January 12 death of Lisa Marie Presley, the then 54-year-old daughter of Elvis and Priscilla Presley. That was the conclusion of the Los Angeles County medical examiner’s office, as reported by Diana Dasrath for NBC News. Dasrath quoted the autopsy report as saying that Presley’s SBO was “in the form of a strangulated small bowel caused by adhesions that developed after bariatric surgery years ago.”
Now, the word strangulated rarely connotes a favorable and stable situation. Typically, you don’t hear people say, “Things got better because my body parts got strangulated,” or “My body parts are getting strangulated right now, but I should be able to make it to dinner shortly.” The Merriam Webster dictionary defines “strangulation” as “to become constricted so as to stop circulation.” So strangulation of your small bowel is where something is squeezing your small bowel to the point that not enough blood can get through into the organ. That would be a medical emergency since no organ in your body can survive for long without fresh blood and the oxygen that such blood brings.
Your small intestines are pretty darn important too. When you eat some sheet cake, for example, that’s where it goes after the piece of cake had gone down your esophagus and past your stomach. Each of the three successive parts of your small intestine—your duodenum, jejunum, and ileum—play vital roles in absorbing different nutrients from that piece of sheet. Your small intestine then moves this piece of sheet further down your gastrointestinal (GI) tract into your colon. When it reaches and moves through your colon, that’s when you have to tell your date, “I’m really enjoying the story about your haircut, but I need to find a bathroom pretty urgently.”
Getting through your small intestine wouldn’t be such a piece of cake if you’ve got a SBO. A SBO may sound a little like HBO but is very different. If you’ve ordered HBO and somehow get a SBO instead, you should demand a refund. But not until you’ve seen a doctor urgently.
There are two general types of SBOs. One is called a functional SBO. That’s where nothing physically blocks the small bowel. Instead, it’s just that your small intestines aren’t contracting adequately to move food along. The walls of your small intestine normally move in wave-like motions kind of like a guy doing the worm on a wedding dance floor. This movement is called peristalsis and would push the piece of sheet and anything else in your small intestine through the intestine sort of like squeezing toothpaste through a tube. A range of things can inhibit normal peristalsis such as different muscle or nerve issues such as damage from abdominal surgery or Parkinson’s disease, medications such as narcotics, and infections. So a functional SBO is indeed when you have little or no small bowel movement in a different way.
The second type of SBO is mechanical SBO. This is where something physically blocks the food gunk from moving through your small intestine. This can happen when the walls of your small intestine become too inflamed such as with some kind inflammatory bowel disease. This can also happen when your small intestine takes a turn for the worse. Intussusception is one such condition. This is where part of your intestine collapses into itself, sort of like a telescope. Another such condition is volvulus. Volvulus is when your intestine gets twisted—twisted in a physical sense rather than a moral and ethical sense. Mechanical SBO can result when masses such as tumors block your small intestine as well.
Then there’s the piece of trap situations. This is when some structure squeezes some part of your small intestine and essentially traps it. One possibility is a hernia. A hernia is when some part of your bowel sticks out of your body through a weakness or opening in the overlying tissue. When that part opening constricts around the bowel, it can lead to a SBO. Scar tissue such as adhesions from surgery can do this as well.
This latter situation appears to have been the case with Presley, based on what the medical examiner reportedly has said. Her autopsy report did mention “adhesions that developed after bariatric surgery years ago.” Bariatric surgery is where a surgeon rearranges and potentially reduces the size of different parts of your gastrointestinal tract such as your stomach and small intestines to facilitate weight loss. Such rearrangement can leave different organs and tissues within the abdomen sticking to each other, hence the name adhesions. It sounds as if these adhesions may have eventually trapped parts of Presley’s small bowel leading to obstruction and even strangulation of the small bowel.
Strangulation is an emergency—typically a surgical emergency. Starving parts of your small bowel of blood oxygen can mean that such tissue will die without quick intervention to restore the blood flow. When the small bowel is not getting adequate blood flow, it’s called small bowel ischemia, which can get life threatening very quickly.
Abdominal pain is the most common symptom of SBO. So is vomiting, constipation, bloating, fever and an elevated heat rate. Abdominal pain is a hallmark of acute small bowel ischemia too. This pain tends to be more sudden and severe. And can be accompanies by a suddenly onset of fever, nausea, vomiting, and severe bloating. You may see blood in your stool as well. Eventually you can descend into mental confusion.
An SBO and small bowel ischemia would be consistent with reports that Presley had been experiencing abdominal pain in the months leading up to her death. That culminated with her being found unresponsive at her home before being rushed to the hospital on the final day of her life. While Presley did have “therapeutic levels” of oxycodone and traces of other substances in her blood, the autopsy report indicated that such things did not contribute to her death.
Will this news finally end all that unfounded speculation from anti-vaccination accounts that Covid-19 vaccines were somehow involved, as I reported for Forbes on January 13? Don’t count on it. Many of those accounts never let facts get in their way.
Read the full article here
