The surgical significance of complete retrograde obstruction of the colon

Summary

Of 44 patients in whom total retrograde large-bowel obstruction was seen on barium-enema studies, half had no clinical evidence of antegrade colonic obstruction; in spite of this, diagnosis of the cause of the obstruction on the basis of barium-enema studies was found to be significantly accurate. The most common cause was carcinoma, either primary or extrinsic, accounting for 64% of the cases. In 23 per cent, the cause was diverticulitis. It is significant that no pathologic changes were found in two patients. Two-thirds of the obstructions occurred in the sigmoid portion of the colon. A decision to perform an emergency operation for large-bowel obstruction should be based upon clinical findings, plain roentgenograms of the abdomen, and barium-enema studies, but not on the results of barium-enema studies alone.