Colonic Conditions: Large Bowel Obstruction

Abstract

Large-bowel obstruction is an emergency condition that requires early identification and intervention, with high morbidity and mortality if left untreated. Clinical presentation is often acute and includes abdominal distention, pain, constipation or obstipation, and nausea and vomiting. It is important to distinguish mechanical obstruction from ileus or pseudo-obstruction, as treatment differs. Ileus and pseudo-obstruction can often be treated non-operatively. Mechanical obstruction, which is most commonly due to a mass, stricture, or volvulus, requires prompt endoscopic or surgical intervention. Intussusception is a special case of mechanical obstruction treatable initially by contrast enema, though most adult cases still require operation.