Large Bowel Obstruction
Management of large bowel obstruction (LBO) is challenging and complex. Colorectal cancer and diverticular stricture are the most common mechanical causes of LBO. Nonmechanical causes, including pseudo-obstruction, have also been described. Regardless, initial management strategies are similar and include aggressive fluid resuscitation, bowel rest, diagnostic imaging, and proximal decompression in the presence of small bowel distension and emesis. CT scan has replaced plain films as the diagnostic modality of choice. Management strategies, such as proximal diversion alone, segmental resection, or endoluminal stenting, are complex and are often guided by the underlying etiology, location of the obstruction, clinical condition of the patient, operative findings, and surgeon and hospital factors.