Management and Causes of Acute Large-Bowel Obstruction

López-Köstner, Francisco; Hool, Graham R.; Lavery, Ian C.

doi:10.1016/s0039-6109(05)70617-4

Cited by 90 publications

(41 citation statements)

References 103 publications

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“…The majority of LBOs are due to neoplasms, most often colon cancer, which accounts for just over 50 % of LBOS. 2,3 In fact, around 10 % of colon cancers initially present with LBO.…”

Section: Etiologymentioning

confidence: 99%

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Colorectal Emergencies: Review and Controversies in the Management of Large Bowel Obstruction

Yeo

Lee

2013

Journal of Gastrointestinal Surgery

104

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Introduction Traditionally, large bowel obstruction (LBO) has been managed as an operative emergency. Its causes and treatments are an important part of general surgical and colon and rectal surgery practices. Discussion While management has traditionally been emergent laparotomy with resection or removal of underlying pathology, newer methodologies and treatments over the last decade have required treating physicians to consider a number of other options, including nonoperative options such as stenting, when treating these patients. Conclusion Given these changes, treating a patient with LBO requires a thoughtful assessment and comprehensive understanding of underlying pathology, assessment of the patient's comorbidities and up-to-date knowledge of modern options for treatment.

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“…The majority of LBOs are due to neoplasms, most often colon cancer, which accounts for just over 50 % of LBOS. 2,3 In fact, around 10 % of colon cancers initially present with LBO.…”

Section: Etiologymentioning

confidence: 99%

“…Volvulus accounts for another 10-17 % of LBO and arises from an axial rotation around the mesentery. 3 Volvulus most often occurs in the sigmoid colon or in the cecum. Diverticular strictures are the cause of around 10 % of LBO.…”

Section: Etiologymentioning

confidence: 99%

Colorectal Emergencies: Review and Controversies in the Management of Large Bowel Obstruction

Yeo

Lee

2013

Journal of Gastrointestinal Surgery

104

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“…Immediate and correct diagnosis of this condition and its etiology is essential, and appropriate treatment is of utmost importance. 12,13 The clinical picture, however, of these patients along with the etiology of obstruction and strangulation prevalence are variable, while appropriate management remains controversial. We, therefore, conducted this prospective study to identify and analyse the clinical presentation of patients with acute mechanical bowel obstruction in our department the etiology of obstruction as well as management and outcome of these patients.…”

Section: Discussionmentioning

confidence: 99%

Causes, evaluation and surgical management of mechanical small bowel obstruction

et al. 2015

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“…CT scan sensibility for high-grade obstruction is about 90%, for low-grade obstruction approximately 50% [6,16]. CT is superior in comparison with abdominal X-ray, ultrasonography and MRI for locating the site of obstruction and diagnosis of bowel ischemia [15,18].…”

Section: Diagnostic Proceduresmentioning

confidence: 99%

“…In patients with pseudo-obstruction, colonoscopic decompression is successful in more than 80% of the cases and further colonoscopy successfully treats the majority of recurrences [16]. After 24 h, the clinical situation has to be reviewed and a decision made if there is a need for further surgical intervention.…”

Section: Therapymentioning

confidence: 99%

Intestinal Obstruction and Perforation – The Role of the Gastroenterologist

Dítě

Lata

Novotný³

2003

Dig Dis

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Intestinal obstruction belongs to highly severe conditions in gastroenterology, namely from the viewpoint of quick and correct diagnosis as well as at determining rational and effective therapy. Etiological multifactorial characteristics leading to processes resulting in mechanical or dynamic obstruction of the intestine, often referred to as paralytic ileus, are undoubtedly serious factors influencing the accuracy of diagnosis and therapeutic approach. Digestive endoscopy is a mandatory method in the diagnosis of intestinal obstructions. Diagnostic endoscopy, colonoscopy in the involvement of the large intestine or enteroscopy in the case of incomplete obstruction of the small intestine are the methods indicated in the majority of obstructive intestinal lesions. Besides their diagnostic importance, they also enable an effective therapeutic approach which may immediately follow the diagnostic intervention. Besides endoscopy that – due to the nature of performance – belongs to invasive methods, the diagnosis of obstructive intestinal processes is unthinkable without the use of non-invasive imaging methods. Abdominal ultrasound examination, a widely applied method, provides – under optimal examination conditions – information, e.g., about the width of the intestinal lumen or about the intestinal wall thickness; however, the specificity of investigation is not always sufficient. Both specificity and sensitivity of exploration are increased by a plain X-ray of the abdomen supplementing the ultrasound examination. Better results are achieved when the abdominal cavity is inspected by means of spiral CT examination that is nowadays not fashionably but highly effectively applied in the modification of the so-called CT enteroclysis or CT colonography. The usage of magnetic resonance (e.g. virtual colonography) is similar, but its efficacy is lower than that of CT examination. From a gastroenterologist’s perspective, endoscopic examination is the fundamental diagnostic and therapeutic method. However, endoscopic examination is initially limited by the cardiopulmonary state of the patient – in a number of cases, first the cardiopulmonary condition must be stabilized, dysbalance of water and mineral state must be restored, and only then can endoscopic investigation be carried out. The application of enteroscopy in small intestine disorders is only suitable in cases where air must be aspirated from the region of the stomach and mainly small intestine as it happens, for example, in acute intestinal pseudo-obstruction. The success of complex conservative therapy in these states is reached in 80% of the cases. In acute and complete intestinal obstruction, a surgical treatment performed in time is the only method. In these cases, the importance of identification of obstruction and timing of the intervention performance from the viewpoint of the patient’s survival is explicitly the principal and life-saving concern. In acute intestinal obstructions developing in patients with malignant affection of the intestine, it is necessary t...

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Management and Causes of Acute Large-Bowel Obstruction

Cited by 90 publications

References 103 publications

Colorectal Emergencies: Review and Controversies in the Management of Large Bowel Obstruction

Colorectal Emergencies: Review and Controversies in the Management of Large Bowel Obstruction

Causes, evaluation and surgical management of mechanical small bowel obstruction

Intestinal Obstruction and Perforation – The Role of the Gastroenterologist

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