Bowel obstruction surgery

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Bowel obstruction Microchapters


Patient Information


Historical Perspective




Differentiating Bowel obstruction from other Diseases

Epidemiology and Demographics

Risk Factors


Natural History, Complications and Prognosis


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]


The mainstay of treatment for bowel obstruction is surgical. Surgery is specifically indicated for complicated bowel obstruction. Complications include: Complete obstruction, closed-loop obstruction, bowel ischemia, necrosis, and perforation.



Indications based upon complicated clinical presentation

Indications based upon image findings

Indications based on a point system

  • A score of more than or equal to 3 indicates surgery, each criterion is allotted one point:

Bowel obstruction in Children

  • Fetal and neonatal bowel obstructions are often caused by an intestinal atresia where there is a narrowing or absence of a part of the intestine.
  • These atresias are often discovered before birth via a sonogram and treated with using laparotomy after birth.
  • If the area affected is small then the surgeon may be able to remove the damaged portion and join the intestine back together.
  • In instances where the narrowing is longer, or the area is damaged and cannot be used for a period of time, a temporary stoma may be placed.

Bowel obstruction in cancer patients

  • Patients with malignancy experience bowel obstruction due to:
  • On average, one third of patients have been found to experience bowel obstruction because of benign adhesions, otherwise the obstructions are often inoperable.
  • If a cancer patient is in remission then the likelihood of a benign adhesion increases.
  • If a cancer patient is not in remission then the likelihood of recurrent cancer increases, meaning that the obstruction is inoperable.
  • A cancer patient may undergo a trial of non-operative management if they do not meet the indications for surgery.

Palliative surgery

Alternatives to surgery


  1. Chen JH, Huang TC, Chang PY, Dai MS, Ho CL, Chen YC, Chao TY, Kao WY (2014). "Malignant bowel obstruction: A retrospective clinical analysis". Mol Clin Oncol. 2 (1): 13–18. doi:10.3892/mco.2013.216. PMC 3915666. PMID 24649301.
  2. Butler JA, Cameron BL, Morrow M, Kahng K, Tom J (1991). "Small bowel obstruction in patients with a prior history of cancer". Am. J. Surg. 162 (6): 624–8. PMID 1727026.
  3. Tang E, Davis J, Silberman H (1995). "Bowel obstruction in cancer patients". Arch Surg. 130 (8): 832–6, discussion 836–7. PMID 7632142.
  4. Dalal KM, Gollub MJ, Miner TJ, Wong WD, Gerdes H, Schattner MA, Jaques DP, Temple LK (2011). "Management of patients with malignant bowel obstruction and stage IV colorectal cancer". J Palliat Med. 14 (7): 822–8. doi:10.1089/jpm.2010.0506. PMID 21595546.
  5. Oyasiji T, Angelo S, Kyriakides TC, Helton SW (2010). "Small bowel obstruction: outcome and cost implications of admitting service". Am Surg. 76 (7): 687–91. PMID 20698371.
  6. Diaz JJ, Bokhari F, Mowery NT, Acosta JA, Block EF, Bromberg WJ, Collier BR, Cullinane DC, Dwyer KM, Griffen MM, Mayberry JC, Jerome R (2008). "Guidelines for management of small bowel obstruction". J Trauma. 64 (6): 1651–64. doi:10.1097/TA.0b013e31816f709e. PMID 18545135.
  7. Paul Olson TJ, Pinkerton C, Brasel KJ, Schwarze ML (2014). "Palliative surgery for malignant bowel obstruction from carcinomatosis: a systematic review". JAMA Surg. 149 (4): 383–92. doi:10.1001/jamasurg.2013.4059. PMC 4030748. PMID 24477929.
  8. Richards WO, Williams LF (1988). "Obstruction of the large and small intestine". Surg. Clin. North Am. 68 (2): 355–76. PMID 3279551.
  9. Ripamonti C, De Conno F, Ventafridda V, Rossi B, Baines MJ (1993). "Management of bowel obstruction in advanced and terminal cancer patients". Ann. Oncol. 4 (1): 15–21. PMID 8435356.


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