Which of the following is a dynamic cause of intestinal obstruction: March 2011
**Core Concept**
A dynamic intestinal obstruction is a type of mechanical obstruction caused by an intraluminal or luminal wall defect that can be moved or manipulated to relieve the obstruction. This is in contrast to a static obstruction, which is caused by a fixed extrinsic compression or external force.
**Why the Correct Answer is Right**
A gallstone (A) can migrate into the intestine and cause a dynamic obstruction by intermittently blocking the intestinal lumen. This type of obstruction can be relieved by manual disimpaction or endoscopic removal of the stone. The movement of the gallstone within the intestine makes it a dynamic cause of obstruction. In contrast, paralytic ileus (B) is a non-mechanical cause of obstruction due to loss of intestinal motility, mesenteric vascular obstruction (C) is a static cause due to external compression, and Ogilvie syndrome (D) is a non-mechanical cause due to impaired intestinal motility.
**Why Each Wrong Option is Incorrect**
**Option B:** Paralytic ileus is a non-mechanical cause of obstruction due to loss of intestinal motility, rather than a dynamic mechanical obstruction.
**Option C:** Mesenteric vascular obstruction is a static cause of obstruction due to external compression, rather than a dynamic mechanical obstruction.
**Option D:** Ogilvie syndrome is a non-mechanical cause of obstruction due to impaired intestinal motility, rather than a dynamic mechanical obstruction.
**Clinical Pearl / High-Yield Fact**
It's essential to differentiate between dynamic and static causes of intestinal obstruction to determine the appropriate management strategy. Dynamic obstructions may require manual or endoscopic relief, while static obstructions may require surgical intervention.
**✓ Correct Answer: A. Gall stone**