Skip to main content
SpringerLink
Log in

Large Bowel Obstruction

  • Chapter
  • First Online:
The ASCRS Textbook of Colon and Rectal Surgery

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Yeo HL, Lee SW. Colorectal emergencies: review and controversies in the management of large bowel obstruction. J Gastrointest Surg. 2013;17(11):2007–12.

    PubMed  Google Scholar 

  2. Ballantyne GH. Review of sigmoid volvulus. Clinical patterns and pathogenesis. Dis Colon Rectum. 1982;25(8):823–30.

    CAS  PubMed  Google Scholar 

  3. Friedman JD, Odland MD, Bubrick MP. Experience with colonic volvulus. Dis Colon Rectum. 1989;32(5):409–16.

    CAS  PubMed  Google Scholar 

  4. Ballantyne GH. Sigmoid volvulus: high mortality in county hospital patients. Dis Colon Rectum. 1981;24(7):515–20.

    CAS  PubMed  Google Scholar 

  5. Schagen van Leeuwen JH. Sigmoid volvulus in a West African population. Dis Colon Rectum. 1985;28(10):712–6.

    CAS  PubMed  Google Scholar 

  6. Rabinovici R, Simansky DA, Kaplan O, Mavor E, Manny J. Cecal volvulus. Dis Colon Rectum. 1990;33(9):765–9.

    CAS  PubMed  Google Scholar 

  7. Saegesser F, Sandblom P. Ischemic lesions of the distended colon: a complication of obstructive colorectal cancer. Am J Surg. 1975;129(3):309–15.

    CAS  PubMed  Google Scholar 

  8. Boley SJ, Agrawal GP, Warren AR, Veith FJ, Levowitz BS, Treiber W, et al. Pathophysiologic effects of bowel distention on intestinal blood flow. Am J Surg. 1969;117(2):228–34.

    CAS  PubMed  Google Scholar 

  9. Stillwell GK. The law of Laplace. Some clinical applications. Mayo Clinic Proc. 1973;48(12):863–9.

    CAS  Google Scholar 

  10. Saegesser F, Chapuis G, Rausis C, Tabrizian M, Sandblom P. Intestinal distension and colonic ischemia: occlusive complications and perforations of colo-rectal cancers. A clinical application of Laplace’s law. Chirurgie. 1974;100(7):502–16.

    CAS  PubMed  Google Scholar 

  11. Saunders MD. Acute colonic pseudo-obstruction. Gastrointest Endosc Clin N Am. 2007;17(2):341–60. vi–vii.

    PubMed  Google Scholar 

  12. De Giorgio R, Knowles CH. Acute colonic pseudo-obstruction. Br J Surg. 2009;96(3):229–39.

    PubMed  Google Scholar 

  13. Vanek VW, Al-Salti M. Acute pseudo-obstruction of the colon (Ogilvie’s syndrome). An analysis of 400 cases. Dis Colon Rectum. 1986;29(3):203–10.

    CAS  PubMed  Google Scholar 

  14. Sawai RS. Management of colonic obstruction: a review. Clin Colon Rectal Surg. 2012;25(4):200–3.

    PubMed  PubMed Central  Google Scholar 

  15. Jain A, Vargas HD. Advances and challenges in the management of acute colonic pseudo-obstruction (ogilvie syndrome). Clin Colon Rectal Surg. 2012;25(1):37–45.

    PubMed  PubMed Central  Google Scholar 

  16. Burrell HC, Baker DM, Wardrop P, Evans AJ. Significant plain film findings in sigmoid volvulus. Clin Radiol. 1994;49(5):317–9.

    CAS  PubMed  Google Scholar 

  17. Osman N, Subar D, Loh MY, Goscimski A. Gallstone ileus of the sigmoid colon: an unusual cause of large-bowel obstruction. HPB Surg. 2010;2010:153740.

    PubMed  PubMed Central  Google Scholar 

  18. Raveenthiran V, Madiba TE, Atamanalp SS, De U. Volvulus of the sigmoid colon. Colorectal Dis. 2010;12(7 Online):e1–17.

    CAS  PubMed  Google Scholar 

  19. Gingold D, Murrell Z. Management of colonic volvulus. Clin Colon Rectal Surg. 2012;25(4):236–44.

    PubMed  PubMed Central  Google Scholar 

  20. Hiltunen KM, Syrja H, Matikainen M. Colonic volvulus. Diagnosis and results of treatment in 82 patients. Eur J Surg. 1992;158(11–12):607–11.

    CAS  PubMed  Google Scholar 

  21. Swenson BR, Kwaan MR, Burkart NE, Wang Y, Madoff RD, Rothenberger DA, et al. Colonic volvulus: presentation and management in metropolitan Minnesota, United States. Dis Colon Rectum. 2012;55(4):444–9.

    PubMed  Google Scholar 

  22. Selcuk Atamanalp S. Treatment for ileosigmoid knotting: a single-center experience of 74 patients. Tech Coloproctol. 2014;18(3):233–7.

    CAS  PubMed  Google Scholar 

  23. Mallick IH, Winslet MC. Ileosigmoid knotting. Colorectal Dis. 2004;6(4):220–5.

    CAS  PubMed  Google Scholar 

  24. Racnic J. Colonic volvulus. In: Beck DE, Roberts PL, Saclarides TJ, Senagore AJ, Stamos MJ, Nasseri Y, editors. The ASCRS textbook of colon and rectal surgery. 2nd ed. New York: Springer; 2011. p. 395–406.

    Google Scholar 

  25. Stewart J, Finan PJ, Courtney DF, Brennan TG. Does a water soluble contrast enema assist in the management of acute large bowel obstruction: a prospective study of 117 cases. Br J Surg. 1984;71(10):799–801.

    CAS  PubMed  Google Scholar 

  26. Koruth NM, Koruth A, Matheson NA. The place of contrast enema in the management of large bowel obstruction. J R Coll Surg Edinb. 1985;30(4):258–60.

    CAS  PubMed  Google Scholar 

  27. Chapman AH, McNamara M, Porter G. The acute contrast enema in suspected large bowel obstruction: value and technique. Clin Radiol. 1992;46(4):273–8.

    CAS  PubMed  Google Scholar 

  28. Sgouros SN, Vlachogiannakos J, Vassiliadis K, Bergele C, Stefanidis G, Nastos H, et al. Effect of polyethylene glycol electrolyte balanced solution on patients with acute colonic pseudo obstruction after resolution of colonic dilation: a prospective, randomised, placebo controlled trial. Gut. 2006;55(5):638–42.

    CAS  PubMed  PubMed Central  Google Scholar 

  29. Vehmas T. Factors influencing the detection of abnormalities in barium enemas performed by junior radiologists. Clin Radiol. 2006;61(3):270–5.

    CAS  PubMed  Google Scholar 

  30. Godfrey EM, Addley HC, Shaw AS. The use of computed tomography in the detection and characterisation of large bowel obstruction. N Z Med J. 2009;122(1305):57–73.

    PubMed  Google Scholar 

  31. Beattie GC, Peters RT, Guy S, Mendelson RM. Computed tomography in the assessment of suspected large bowel obstruction. ANZ J Surg. 2007;77(3):160–5.

    PubMed  Google Scholar 

  32. Jacob SE, Lee SH, Hill J. The demise of the instant/unprepared contrast enema in large bowel obstruction. Colorectal Dis. 2008;10(7):729–31.

    CAS  PubMed  Google Scholar 

  33. Frager D, Rovno HD, Baer JW, Bashist B, Friedman M. Prospective evaluation of colonic obstruction with computed tomography. Abdom Imaging. 1998;23(2):141–6.

    CAS  PubMed  Google Scholar 

  34. Lopez-Kostner F, Hool GR, Lavery IC. Management and causes of acute large-bowel obstruction. Surg Clin N Am. 1997;77(6):1265–90.

    CAS  PubMed  Google Scholar 

  35. Gutman M, Kaplan O, Skornick Y, Greif F, Kahn P, Rozin RR. Proximal colostomy: still an effective emergency measure in obstructing carcinoma of the large bowel. J Surg Oncol. 1989;41(3):210–2.

    CAS  PubMed  Google Scholar 

  36. Kronborg O. Acute obstruction from tumour in the left colon without spread. A randomized trial of emergency colostomy versus resection. Int J Colorectal Dis. 1995;10(1):1–5.

    CAS  PubMed  Google Scholar 

  37. Hsu TC. Comparison of one-stage resection and anastomosis of acute complete obstruction of left and right colon. Am J Surg. 2005;189(4):384–7.

    PubMed  Google Scholar 

  38. Lee YM, Law WL, Chu KW, Poon RT. Emergency surgery for obstructing colorectal cancers: a comparison between right-sided and left-sided lesions. J Am Coll Surg. 2001;192(6):719–25.

    CAS  PubMed  Google Scholar 

  39. Sajid MS, Caswell J, Bhatti MI, Sains P, Baig MK, Miles WF. Carbon dioxide insufflation versus conventional air insufflation for colonoscopy: a systematic review and meta-analysis of published randomized controlled trials. Colorectal Dis. 2015;17:111–23.

    Google Scholar 

  40. Bretthauer M, Lynge AB, Thiis-Evensen E, Hoff G, Fausa O, Aabakken L. Carbon dioxide insufflation in colonoscopy: safe and effective in sedated patients. Endoscopy. 2005;37(8):706–9.

    CAS  PubMed  Google Scholar 

  41. Yasumasa K, Nakajima K, Endo S, Ito T, Matsuda H, Nishida T. Carbon dioxide insufflation attenuates parietal blood flow obstruction in distended colon: potential advantages of carbon dioxide insufflated colonoscopy. Surg Endosc. 2006;20(4):587–94.

    CAS  PubMed  Google Scholar 

  42. Dohmoto M. New method: endoscopic implantation of rectal stent in palliative treatment of malignant stenosis. Endosc Dig. 1991;3:1507–12.

    Google Scholar 

  43. Tejero E, Mainar A, Fernandez L, Tobio R, De Gregorio MA. New procedure for the treatment of colorectal neoplastic obstructions. Dis Colon Rectum. 1994;37(11):1158–9.

    CAS  PubMed  Google Scholar 

  44. Tejero E, Fernandez-Lobato R, Mainar A, Montes C, Pinto I, Fernandez L, et al. Initial results of a new procedure for treatment of malignant obstruction of the left colon. Dis Colon Rectum. 1997;40(4):432–6.

    CAS  PubMed  Google Scholar 

  45. Gandrup P, Lund L, Balslev I. Surgical treatment of acute malignant large bowel obstruction. Eur J Surg. 1992;158(8):427–30.

    CAS  PubMed  Google Scholar 

  46. Lee HJ, Hong SP, Cheon JH, Kim TI, Min BS, Kim NK, et al. Long-term outcome of palliative therapy for malignant colorectal obstruction in patients with unresectable metastatic colorectal cancers: endoscopic stenting versus surgery. Gastrointest Endosc. 2011;73(3):535–42.

    PubMed  Google Scholar 

  47. Bonin EA, Baron TH. Update on the indications and use of colonic stents. Curr Gastroenterol Rep. 2010;12(5):374–82.

    PubMed  Google Scholar 

  48. Cheung HY, Chung CC, Tsang WW, Wong JC, Yau KK, Li MK. Endolaparoscopic approach vs conventional open surgery in the treatment of obstructing left-sided colon cancer: a randomized controlled trial. Arch Surg. 2009;144(12):1127–32.

    PubMed  Google Scholar 

  49. Watt AM, Faragher IG, Griffin TT, Rieger NA, Maddern GJ. Self-expanding metallic stents for relieving malignant colorectal obstruction: a systematic review. Ann Surg. 2007;246(1):24–30.

    PubMed  PubMed Central  Google Scholar 

  50. van Hooft JE, Fockens P, Marinelli AW, Timmer R, van Berkel AM, Bossuyt PM, et al. Early closure of a multicenter randomized clinical trial of endoscopic stenting versus surgery for stage IV left-sided colorectal cancer. Endoscopy. 2008;40(3):184–91.

    PubMed  Google Scholar 

  51. Khot UP, Lang AW, Murali K, Parker MC. Systematic review of the efficacy and safety of colorectal stents. Br J Surg. 2002;89(9):1096–102.

    CAS  PubMed  Google Scholar 

  52. van Hooft JE, van Halsema EE, Vanbiervliet G, Beets-Tan RG, DeWitt JM, Donnellan F, et al. Self-expandable metal stents for obstructing colonic and extracolonic cancer: European Society of Gastrointestinal Endoscopy (ESGE) Clinical Guideline. Gastrointest Endosc. 2014;80(5):747–61. e1-75.

    PubMed  Google Scholar 

  53. Small AJ, Coelho-Prabhu N, Baron TH. Endoscopic placement of self-expandable metal stents for malignant colonic obstruction: long-term outcomes and complication factors. Gastrointest Endosc. 2010;71(3):560–72.

    PubMed  Google Scholar 

  54. Cennamo V, Fuccio L, Mutri V, Minardi ME, Eusebi LH, Ceroni L, et al. Does stent placement for advanced colon cancer increase the risk of perforation during bevacizumab-based therapy? Clin Gastroenterol Hepatol. 2009;7(11):1174–6.

    PubMed  Google Scholar 

  55. Pirlet IA, Slim K, Kwiatkowski F, Michot F, Millat BL. Emergency preoperative stenting versus surgery for acute left-sided malignant colonic obstruction: a multicenter randomized controlled trial. Surg Endosc. 2011;25(6):1814–21.

    PubMed  Google Scholar 

  56. van Hooft JE, Bemelman WA, Oldenburg B, Marinelli AW, Lutke Holzik MF, Grubben MJ, et al. Colonic stenting versus emergency surgery for acute left-sided malignant colonic obstruction: a multicentre randomised trial. Lancet Oncol. 2011;12(4):344–52.

    PubMed  Google Scholar 

  57. Farrell JJ. Preoperative colonic stenting: how, when and why? Curr Opin Gastroenterol. 2007;23(5):544–9.

    PubMed  Google Scholar 

  58. Sebastian S, Johnston S, Geoghegan T, Torreggiani W, Buckley M. Pooled analysis of the efficacy and safety of self-expanding metal stenting in malignant colorectal obstruction. Am J Gastroenterol. 2004;99(10):2051–7.

    PubMed  Google Scholar 

  59. Sagar J. Colorectal stents for the management of malignant colonic obstructions. Cochrane Database Syst Rev. 2011(11):CD007378.

    Google Scholar 

  60. Choi JH, Lee YJ, Kim ES, Choi JH, Cho KB, Park KS, et al. Covered self-expandable metal stents are more associated with complications in the management of malignant colorectal obstruction. Surg Endosc. 2013;27(9):3220–7.

    PubMed  Google Scholar 

  61. Kim BK, Hong SP, Heo HM, Kim JY, Hur H, Lee KY, et al. Endoscopic stenting is not as effective for palliation of colorectal obstruction in patients with advanced gastric cancer as emergency surgery. Gastrointest Endosc. 2012;75(2):294–301.

    PubMed  Google Scholar 

  62. Meisner S, Hensler M, Knop FK, West F, Wille-Jorgensen P. Self-expanding metal stents for colonic obstruction: experiences from 104 procedures in a single center. Dis Colon Rectum. 2004;47(4):444–50.

    PubMed  Google Scholar 

  63. Paul L, Pinto I, Gomez H, Fernandez-Lobato R, Moyano E. Metallic stents in the treatment of benign diseases of the colon: preliminary experience in 10 cases. Radiology. 2002;223(3):715–22.

    PubMed  Google Scholar 

  64. Repici A, Adler DG, Gibbs CM, Malesci A, Preatoni P, Baron TH. Stenting of the proximal colon in patients with malignant large bowel obstruction: techniques and outcomes. Gastrointest Endosc. 2007;66(5):940–4.

    PubMed  Google Scholar 

  65. Wangensteen OH. Cancer of the colon and rectum; with special reference to earlier recognition of alimentary tract malignancy; secondary delayed re-entry of the abdomen in patients exhibiting lymph node involvement; subtotal primary excision of the colon; operation in obstruction. Wisconsin Med J. 1949;48(7):591–7.

    CAS  PubMed  Google Scholar 

  66. Chereau N, Lefevre JH, Lefrancois M, Chafai N, Parc Y, Tiret E. Management of malignant left colonic obstruction: is an initial temporary colostomy followed by surgical resection a better option? Colorectal Dis. 2013;15(11):e646–53.

    CAS  PubMed  Google Scholar 

  67. Maggard MA, Zingmond D, O’Connell JB, Ko CY. What proportion of patients with an ostomy (for diverticulitis) get reversed? Am Surg. 2004;70(10):928–31.

    PubMed  Google Scholar 

  68. Vermeulen J, Coene PP, Van Hout NM, van der Harst E, Gosselink MP, Mannaerts GH, et al. Restoration of bowel continuity after surgery for acute perforated diverticulitis: should Hartmann’s procedure be considered a one-stage procedure? Colorectal Dis. 2009;11(6):619–24.

    CAS  PubMed  Google Scholar 

  69. Toro A, Mannino M, Reale G, Cappello G, Di Carlo I. Primary anastomosis vs. Hartmann procedure in acute complicated diverticulitis. Evolution over the last twenty years. Chirurgia (Bucharest, Romania: 1990). 2012;107(5):598–604.

    CAS  PubMed  Google Scholar 

  70. Banerjee S, Leather AJ, Rennie JA, Samano N, Gonzalez JG, Papagrigoriadis S. Feasibility and morbidity of reversal of Hartmann’s. Colorectal Dis. 2005;7(5):454–9.

    CAS  PubMed  Google Scholar 

  71. Foster ME, Leaper DJ, Williamson RC. Changing patterns in colostomy closure: the Bristol experience 1975–1982. Br J Surg. 1985;72(2):142–5.

    CAS  PubMed  Google Scholar 

  72. Sweeney JL, Hoffmann DC. Restoration of continuity after Hartmann’s procedure for the complications of diverticular disease. Aust NZ J Surg. 1987;57(11):823–5.

    CAS  Google Scholar 

  73. Wigmore SJ, Duthie GS, Young IE, Spalding EM, Rainey JB. Restoration of intestinal continuity following Hartmann’s procedure: the Lothian experience 1987–1992. Br J Surg. 1995;82(1):27–30.

    CAS  PubMed  Google Scholar 

  74. Geoghegan JG, Rosenberg IL. Experience with early anastomosis after the Hartmann procedure. Ann R Coll Surg Engl. 1991;73(2):80–2.

    CAS  PubMed  PubMed Central  Google Scholar 

  75. Garber A, Hyman N, Osler T. Complications of Hartmann takedown in a decade of preferred primary anastomosis. Am J Surg. 2014;207(1):60–4.

    PubMed  Google Scholar 

  76. van de Wall BJ, Draaisma WA, Schouten ES, Broeders IA, Consten EC. Conventional and laparoscopic reversal of the Hartmann procedure: a review of literature. J Gastrointest Surg. 2010;14(4):743–52.

    PubMed  Google Scholar 

  77. Schilling MK, Maurer CA, Kollmar O, Buchler MW. Primary vs. secondary anastomosis after sigmoid colon resection for perforated diverticulitis (Hinchey Stage III and IV): a prospective outcome and cost analysis. Dis Colon Rectum. 2001;44(5):699–703; discussion 5.

    CAS  PubMed  Google Scholar 

  78. Sule AZ, Misauno M, Opaluwa AS, Ojo E. One-stage treatment of left-sided large bowel emergencies. East African Med J. 2008;85(2):80–4.

    CAS  Google Scholar 

  79. Poon RT, Law WL, Chu KW, Wong J. Emergency resection and primary anastomosis for left-sided obstructing colorectal carcinoma in the elderly. Br J Surg. 1998;85(11):1539–42.

    CAS  PubMed  Google Scholar 

  80. Goyal A, Schein M. Current practices in left-sided colonic emergencies: a survey of US gastrointestinal surgeons. Dig Surg. 2001;18(5):399–402.

    CAS  PubMed  Google Scholar 

  81. Singhal R, Hull P, Budhoo M. Management of left sided colorectal emergencies. Results of a postal questionnaire. Minerva Chirurgica. 2007;62(6):437–41.

    CAS  PubMed  Google Scholar 

  82. Engledow AH, Bond-Smith G, Motson RW, Jenkinson A. Treatment of left-sided colonic emergencies: a comparison of US and UK surgical practices. Colorectal Dis. 2009;11(6):642–7.

    CAS  PubMed  Google Scholar 

  83. Single-stage treatment for malignant left-sided colonic obstruction: a prospective randomized clinical trial comparing subtotal colectomy with segmental resection following intraoperative irrigation. The SCOTIA Study Group. Subtotal Colectomy versus On-table Irrigation and Anastomosis. Br J Surg. 1995;82(12):1622–7.

    Google Scholar 

  84. You YN, Chua HK, Nelson H, Hassan I, Barnes SA, Harrington J. Segmental vs. extended colectomy: measurable differences in morbidity, function, and quality of life. Dis Colon Rectum. 2008;51(7):1036–43.

    PubMed  Google Scholar 

  85. Eskicioglu C, Forbes SS, Fenech DS, McLeod RS. Best practice in General Surgery C. Preoperative bowel preparation for patients undergoing elective colorectal surgery: a clinical practice guideline endorsed by the Canadian Society of Colon and Rectal Surgeons. Can J Surg. 2010;53(6):385–95.

    PubMed  PubMed Central  Google Scholar 

  86. Smith SR, Connolly JC, Gilmore OJ. The effect of faecal loading on colonic anastomotic healing. Br J Surg. 1983;70(1):49–50.

    CAS  PubMed  Google Scholar 

  87. Sasaki K, Kazama S, Sunami E, Tsuno NH, Nozawa H, Nagawa H, et al. One-stage segmental colectomy and primary anastomosis after intraoperative colonic irrigation and total colonoscopy for patients with obstruction due to left-sided colorectal cancer. Dis Colon Rectum. 2012;55(1):72–8.

    PubMed  Google Scholar 

  88. Jung SH, Kim JH. Comparative study of postoperative complications in patients with and without an obstruction who had left-sided colorectal cancer and underwent a single-stage operation after mechanical bowel preparation. Ann Coloproctol. 2014;30(6):251–8.

    PubMed  PubMed Central  Google Scholar 

  89. Murray JJ, Schoetz Jr DJ, Coller JA, Roberts PL, Veidenheimer MC. Intraoperative colonic lavage and primary anastomosis in nonelective colon resection. Dis Colon Rectum. 1991;34(7):527–31.

    CAS  PubMed  Google Scholar 

  90. Forloni B, Reduzzi R, Paludetti A, Colpani L, Cavallari G, Frosali D. Intraoperative colonic lavage in emergency surgical treatment of left-sided colonic obstruction. Dis Colon Rectum. 1998;41(1):23–7.

    CAS  PubMed  Google Scholar 

  91. Torralba JA, Robles R, Parrilla P, Lujan JA, Liron R, Pinero A, et al. Subtotal colectomy vs. intraoperative colonic irrigation in the management of obstructed left colon carcinoma. Dis Colon Rectum. 1998;41(1):18–22.

    CAS  PubMed  Google Scholar 

  92. Hsu TC. One-stage resection and anastomosis for acute obstruction of the left colon. Dis Colon Rectum. 1998;41(1):28–32.

    CAS  PubMed  Google Scholar 

  93. Cross KL, Rees JR, Soulsby RH, Dixon AR. Primary anastomosis without colonic lavage for the obstructed left colon. Ann R Coll Surg Engl. 2008;90(4):302–4.

    CAS  PubMed  PubMed Central  Google Scholar 

  94. Naraynsingh V, Rampaul R, Maharaj D, Kuruvilla T, Ramcharan K, Pouchet B. Prospective study of primary anastomosis without colonic lavage for patients with an obstructed left colon. Br J Surg. 1999;86(10):1341–3.

    CAS  PubMed  Google Scholar 

  95. Alcantara M, Serra-Aracil X, Falco J, Mora L, Bombardo J, Navarro S. Prospective, controlled, randomized study of intraoperative colonic lavage versus stent placement in obstructive left-sided colonic cancer. World J Surg. 2011;35(8):1904–10.

    CAS  PubMed  Google Scholar 

  96. Ballantyne GH, Brandner MD, Beart Jr RW, Ilstrup DM. Volvulus of the colon. Incidence and mortality. Ann Surg. 1985;202(1):83–92.

    CAS  PubMed  PubMed Central  Google Scholar 

  97. Atamanalp SS, Ozturk G. Sigmoid volvulus in the elderly: outcomes of a 43-year, 453-patient experience. Surg Today. 2011;41(4):514–9.

    PubMed  Google Scholar 

  98. Feldman D. The coffee bean sign. Radiology. 2000;216(1):178–9.

    CAS  PubMed  Google Scholar 

  99. Levsky JM, Den EI, DuBrow RA, Wolf EL, Rozenblit AM. CT findings of sigmoid volvulus. Am J Roentgenol. 2010;194(1):136–43.

    Google Scholar 

  100. Macari M, Spieler B, Babb J, Pachter HL. Can the location of the CT whirl sign assist in differentiating sigmoid from caecal volvulus? Clin Radiol. 2011;66(2):112–7.

    CAS  PubMed  Google Scholar 

  101. Turan M, Sen M, Karadayi K, Koyuncu A, Topcu O, Yildirir C, et al. Our sigmoid colon volvulus experience and benefits of colonoscope in detortion process. Rev Esp Enferm Dig. 2004;96(1):32–5.

    CAS  PubMed  Google Scholar 

  102. Bruzzi M, Lefevre JH, Desaint B, Nion-Larmurier I, Bennis M, Chafai N, et al. Management of acute sigmoid volvulus: short- and long-term results. Colorectal Dis. 2015;17:922–8.

    Google Scholar 

  103. Hougaard HT, Qvist N. Elective surgery after successful endoscopic decompression of sigmoid volvulus may be considered. Danish Med J. 2013;60(7):A4660.

    Google Scholar 

  104. Basato S, Lin Sun Fui S, Pautrat K, Tresallet C, Pocard M. Comparison of two surgical techniques for resection of uncomplicated sigmoid volvulus: laparoscopy or open surgical approach? J Visc Surg. 2014;151(6):431–4.

    CAS  PubMed  Google Scholar 

  105. Choi BJ, Jeong WJ, Kim SJ, Lee SC. Single-port laparoscopic surgery for sigmoid volvulus. World J Gastroenterol. 2015;21(8):2381–6.

    Google Scholar 

  106. Chandrasekaran TV, Al-Dahiri A, Beynon J, Carr ND. Minimally invasive stapled surgical approach to the management of sigmoid volvulus. Ann R Coll Surg Engl. 2005;87(5):381–2.

    CAS  PubMed  PubMed Central  Google Scholar 

  107. Hsu TC. Feasibility of colectomy with mini-incision. Am J Surg. 2005;190(1):48–50.

    PubMed  Google Scholar 

  108. Suleyman O, Kessaf AA, Ayhan KM. Sigmoid volvulus: long-term surgical outcomes and review of the literature. S Afr J Surg. 2012;50(1):9–15.

    PubMed  Google Scholar 

  109. Atamanalp SS. Treatment of sigmoid volvulus: a single-center experience of 952 patients over 46.5 years. Tech Coloproctol. 2013;17(5):561–9.

    CAS  PubMed  Google Scholar 

  110. Chung YF, Eu KW, Nyam DC, Leong AF, Ho YH, Seow-Choen F. Minimizing recurrence after sigmoid volvulus. Br J Surg. 1999;86(2):231–3.

    CAS  PubMed  Google Scholar 

  111. Morrissey TB, Deitch EA. Recurrence of sigmoid volvulus after surgical intervention. Am Surg. 1994;60(5):329–31.

    CAS  PubMed  Google Scholar 

  112. Bhatnagar BN, Sharma CL. Nonresective alternative for the cure of nongangrenous sigmoid volvulus. Dis Colon Rectum. 1998;41(3):381–8.

    CAS  PubMed  Google Scholar 

  113. Gordon-Weeks AN, Lorenzi B, Lim J, Cristaldi M. Laparoscopic-assisted endoscopic sigmoidopexy: a new surgical option for sigmoid volvulus. Dis Colon Rectum. 2011;54(5):645–7.

    PubMed  Google Scholar 

  114. Bach O, Rudloff U, Post S. Modification of mesosigmoidoplasty for nongangrenous sigmoid volvulus. World J Surg. 2003;27(12):1329–32.

    PubMed  Google Scholar 

  115. Ponticelli A, Mastrobuono I, Matarazzo E, Zaccara A, Appetito C, Inserra A, et al. Mesosigmoidoplasty in the treatment of sigmoid volvulus in children. S Afr J Surg. 1989;27(3):105–7.

    CAS  PubMed  Google Scholar 

  116. Mortensen NJ, Hoffman G. Volvulus of the transverse colon. Postgraduate Med J. 1979;55(639):54–7.

    CAS  Google Scholar 

  117. Gupta SS, Singh O, Paramhans D, Mathur RK. Tube sigmoidostomy: a valuable alternative to sigmoidopexy for sigmoid volvulus. J Visc Surg. 2011;148(2):e129–33.

    CAS  PubMed  Google Scholar 

  118. Ifversen AK, Kjaer DW. More patients should undergo surgery after sigmoid volvulus. World J Gastroenterol. 2014;20(48):18384–9.

    PubMed  PubMed Central  Google Scholar 

  119. Khan MA, Ullah S, Beckly D, Oppong FC. Percutaneous endoscopic colostomy (PEC): an effective alternative in high risk patients with recurrent sigmoid volvulus. J Coll Physicians Surg Pak. 2013;23(10):806–8.

    PubMed  Google Scholar 

  120. Baraza W, Brown S, McAlindon M, Hurlstone P. Prospective analysis of percutaneous endoscopic colostomy at a tertiary referral centre. Br J Surg. 2007;94(11):1415–20.

    CAS  PubMed  Google Scholar 

  121. Kuzu MA, Aslar AK, Soran A, Polat A, Topcu O, Hengirmen S. Emergent resection for acute sigmoid volvulus: results of 106 consecutive cases. Dis Colon Rectum. 2002;45(8):1085–90.

    PubMed  Google Scholar 

  122. Oren D, Atamanalp SS, Aydinli B, Yildirgan MI, Basoglu M, Polat KY, et al. An algorithm for the management of sigmoid colon volvulus and the safety of primary resection: experience with 827 cases. Dis Colon Rectum. 2007;50(4):489–97.

    PubMed  Google Scholar 

  123. Aftab Z, Toro A, Abdelaal A, Dasovky M, Gehani S, Abdel Mola A, et al. Endoscopic reduction of a volvulus of the sigmoid colon in pregnancy: case report and a comprehensive review of the literature. World J Emerg Surg. 2014;9:41.

    PubMed  PubMed Central  Google Scholar 

  124. Atamanalp SS, Kisaoglu A, Ozogul B. Factors affecting bowel gangrene development in patients with sigmoid volvulus. Ann Saudi Med. 2013;33(2):144–8.

    PubMed  PubMed Central  Google Scholar 

  125. Vandendries C, Julles MC, Boulay-Coletta I, Loriau J, Zins M. Diagnosis of colonic volvulus: findings on multidetector CT with three-dimensional reconstructions. Br J Radiol. 2010;83(995):983–90.

    CAS  PubMed  PubMed Central  Google Scholar 

  126. Consorti ET, Liu TH. Diagnosis and treatment of caecal volvulus. Postgraduate Med J. 2005;81(962):772–6.

    CAS  Google Scholar 

  127. Tuech JJ, Becouarn G, Cattan F, Arnaud JP. Volvulus of the right colon. Plea for right hemicolectomy. Apropos of a series of 23 cases. Chirurgie. 1996;133(6):267–9.

    CAS  Google Scholar 

  128. Madiba TE, Thomson SR. The management of cecal volvulus. Dis Colon Rectum. 2002;45(2):264–7.

    CAS  PubMed  Google Scholar 

  129. Puthu D, Rajan N, Shenoy GM, Pai SU. The ileosigmoid knot. Dis Colon Rectum. 1991;34(2):161–6.

    CAS  PubMed  Google Scholar 

  130. Alver O, Oren D, Tireli M, Kayabasi B, Akdemir D. Ileosigmoid knotting in Turkey. Review of 68 cases. Dis Colon Rectum. 1993;36(12):1139–47.

    CAS  PubMed  Google Scholar 

  131. Halabi WJ, Jafari MD, Kang CY, Nguyen VQ, Carmichael JC, Mills S, et al. Colonic volvulus in the United States: trends, outcomes, and predictors of mortality. Ann Surg. 2014;259(2):293–301.

    PubMed  Google Scholar 

  132. Plorde JJ, Raker EJ. Transverse colon volvulus and associated Chilaiditi’s syndrome: case report and literature review. Am J Gastroenterol. 1996;91(12):2613–6.

    CAS  PubMed  Google Scholar 

  133. Moaven O, Hodin RA. Chilaiditi syndrome: a rare entity with important differential diagnoses. Gastroenterol Hepatol. 2012;8(4):276–8.

    Google Scholar 

  134. Mindelzun RE, Stone JM. Volvulus of the splenic flexure: radiographic features. Radiology. 1991;181(1):221–3.

    CAS  PubMed  Google Scholar 

  135. Chen MH, Chou CM, Lin CC. Transverse colon volvulus presenting as ‘inverted’ coffee-bean sign. Arch Dis Child. 2012;97(2):123.

    PubMed  Google Scholar 

  136. Choi JS, Lim JS, Kim H, Choi JY, Kim MJ, Kim NK, et al. Colonic pseudoobstruction: CT findings. Am J Roentgenol. 2008;190(6):1521–6.

    Google Scholar 

  137. Wegener M, Borsch G. Acute colonic pseudo-obstruction (Ogilvie’s syndrome). Presentation of 14 of our own cases and analysis of 1027 cases reported in the literature. Surg Endosc. 1987;1(3):169–74.

    CAS  PubMed  Google Scholar 

  138. Ponec RJ, Saunders MD, Kimmey MB. Neostigmine for the treatment of acute colonic pseudo-obstruction. N Engl J Med. 1999;341(3):137–41.

    CAS  PubMed  Google Scholar 

  139. van der Spoel JI, Oudemans-van Straaten HM, Stoutenbeek CP, Bosman RJ, Zandstra DF. Neostigmine resolves critical illness-related colonic ileus in intensive care patients with multiple organ failure—a prospective, double-blind, placebo-controlled trial. Intensive Care Med. 2001;27(5):822–7.

    PubMed  Google Scholar 

  140. Amaro R, Rogers AI. Neostigmine infusion: new standard of care for acute colonic pseudo-obstruction? Am J Gastroenterol. 2000;95(1):304–5.

    CAS  PubMed  Google Scholar 

  141. Stephenson BM, Morgan AR, Salaman JR, Wheeler MH. Ogilvie’s syndrome: a new approach to an old problem. Dis Colon Rectum. 1995;38(4):424–7.

    CAS  PubMed  Google Scholar 

  142. Valle RG, Godoy FL. Neostigmine for acute colonic pseudo-obstruction: a meta-analysis. Ann Med Surg. 2014;3(3):60–4.

    Google Scholar 

  143. White L, Sandhu G. Continuous neostigmine infusion versus bolus neostigmine in refractory Ogilvie syndrome. Am J Emerg Med. 2011;29(5):576. e1–3.

    Google Scholar 

  144. O’Dea CJ, Brookes JH, Wattchow DA. The efficacy of treatment of patients with severe constipation or recurrent pseudo-obstruction with pyridostigmine. Colorectal Dis. 2010;12(6):540–8.

    PubMed  Google Scholar 

  145. Weinstock LB, Chang AC. Methylnaltrexone for treatment of acute colonic pseudo-obstruction. J Clin Gastroenterol. 2011;45(10):883–4.

    CAS  PubMed  Google Scholar 

  146. Smart CJ, Ramesh AN. The successful treatment of acute refractory pseudo-obstruction with prucalopride. Colorectal Dis. 2012;14(8), e508.

    CAS  PubMed  Google Scholar 

  147. Harrison ME, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T, Cash BD, et al. The role of endoscopy in the management of patients with known and suspected colonic obstruction and pseudo-obstruction. Gastrointest Endosc. 2010;71(4):669–79.

    PubMed  Google Scholar 

  148. Wang WL, Wu ZH, Sun Q, Wei JF, Chen XF, Zhou DK, et al. Meta-analysis: the use of carbon dioxide insufflation vs. room air insufflation for gastrointestinal endoscopy. Aliment Pharmacol Ther. 2012;35(10):1145–54.

    CAS  PubMed  Google Scholar 

  149. Wiersema US, Bruno MJ, Tjwa ET. On colonoscopy in acute colonic pseudo obstruction. Eur J Intern Med. 2013;24(8):e86–7.

    PubMed  Google Scholar 

  150. Rex DK. Colonoscopy and acute colonic pseudo-obstruction. Gastrointest Endosc Clin N Am. 1997;7(3):499–508.

    CAS  PubMed  Google Scholar 

  151. Lynch CR, Jones RG, Hilden K, Wills JC, Fang JC. Percutaneous endoscopic cecostomy in adults: a case series. Gastrointest Endosc. 2006;64(2):279–82.

    PubMed  Google Scholar 

  152. Pereira P, Djeudji F, Leduc P, Fanget F, Barth X. Ogilvie’s syndrome-acute colonic pseudo-obstruction. J Visc Surg. 2015;152:99–105.

    Google Scholar 

  153. Bailey HR, Ott MT, Hartendorp P. Aggressive surgical management for advanced colorectal endometriosis. Dis Colon Rectum. 1994;37(8):747–53.

    CAS  PubMed  Google Scholar 

  154. Ruffo G, Crippa S, Sartori A, Partelli S, Minelli L, Falconi M. Management of rectosigmoid obstruction due to severe bowel endometriosis. Updates Surg. 2014;66(1):59–64.

    PubMed  Google Scholar 

  155. Giudice LC, Kao LC. Endometriosis. Lancet. 2004;364(9447):1789–99.

    PubMed  Google Scholar 

  156. de Jong MJ, Mijatovic V, van Waesberghe JH, Cuesta MA, Hompes PG. Surgical outcome and long-term follow-up after segmental colorectal resection in women with a complete obstruction of the rectosigmoid due to endometriosis. Digest Surg. 2009;26(1):50–5.

    Google Scholar 

  157. Wald A. Management and prevention of fecal impaction. Curr Gastroenterol Rep. 2008;10(5):499–501.

    PubMed  Google Scholar 

  158. Reisner RM, Cohen JR. Gallstone ileus: a review of 1001 reported cases. Am Surg. 1994;60(6):441–6.

    CAS  PubMed  Google Scholar 

  159. Howard N, Pranesh N, Carter P. Colo-colonic intusussception secondary to a lipoma. Int J Surg Case Rep. 2012;3(2):52–4.

    PubMed  Google Scholar 

  160. Wilson A, Elias G, Dupiton R. Adult colocolic intussusception and literature review. Case Rep Gastroenterol. 2013;7(3):381–7.

    PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Division of Colon and Rectal Surgery, Department of Surgery, University of Massachusetts Medical School, 67 Belmont Street, Worcester, MA, 01772, USA

    Karim Alavi M.D., M.P.H.

  2. Department of Surgery, University of Virginia Medical Center, Charlottesville, VA, USA

    Charles M. Friel M.D.

Authors
  1. Karim Alavi M.D., M.P.H.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Charles M. Friel M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Karim Alavi M.D., M.P.H. .

Editor information

Editors and Affiliations

  1. Division of Colorectal Surgery, University Hospitals Case Medical Center Case Western Reserve University, Cleveland, OH, USA

    Scott R. Steele

  2. Cleveland Clinic, Cleveland, OH, USA

    Tracy L. Hull

  3. Tufts University School of Medicine, Lahey Hospital & Medical Center, Burlington, MA, USA

    Thomas E. Read

  4. Ambrose and Gladys Bowyer, Loyola University, Chicago, IL, USA

    Theodore J. Saclarides

  5. University of Texas Medical Branch at Galveston, Galveston, TX, USA

    Anthony J. Senagore

  6. Ochsner Medical Center, New Orleans, LA, USA

    Charles B. Whitlow

Rights and permissions

Reprints and permissions

Copyright information

© 2016 ASCRS (American Society of Colon and Rectal Surgeons)

About this chapter

Cite this chapter

Alavi, K., Friel, C.M. (2016). Large Bowel Obstruction. In: Steele, S.R., Hull, T.L., Read, T.E., Saclarides, T.J., Senagore, A.J., Whitlow, C.B. (eds) The ASCRS Textbook of Colon and Rectal Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-25970-3_40

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-25970-3_40

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-25968-0

  • Online ISBN: 978-3-319-25970-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation