Large bowel obstruction - Revision history

Ostermayer: Prepared the page for translation

2026-01-04T23:16:42Z

Prepared the page for translation

← Revisión anterior		Revisión del 23:16 4 ene 2026
Línea 1:		Línea 1:
			<languages/>
			<translate>

	==Background==		==Background==

	[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]		[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]
	*Much less common than [[SBO]], but more ominous (frequently associated with malignancy)		*Much less common than [[Special:MyLanguage/SBO\|SBO]], but more ominous (frequently associated with malignancy)
	**LBO more common in elderly, and generally has more insidious onset than SBO		**LBO more common in elderly, and generally has more insidious onset than SBO
	*Most commonly occurs in the left (descending) colon		*Most commonly occurs in the left (descending) colon
	**Obstruction originating from the left colon is likely to manifest with symptoms earlier than obstruction originating from the right colon, because the lumen from the descending colon and the sigmoid is smaller.		**Obstruction originating from the left colon is likely to manifest with symptoms earlier than obstruction originating from the right colon, because the lumen from the descending colon and the sigmoid is smaller.


	===Causes===		===Causes===

	*Neoplasm (most common cause)		*Neoplasm (most common cause)
	*Adhesions		*Adhesions
	*[[Diverticulitis\|Diverticular disease]]		*[[Special:MyLanguage/Diverticulitis\|Diverticular disease]]
	*[[Fecal impaction]]		*[[Special:MyLanguage/Fecal impaction\|Fecal impaction]]
	*[[Hernia\|Hernias]]		*[[Special:MyLanguage/Hernia\|Hernias]]
	*Strictures		*Strictures
	*Pseudo-obstruction (e.g. [[Ogilvie's Syndrome]])		*Pseudo-obstruction (e.g. [[Special:MyLanguage/Ogilvie's Syndrome\|Ogilvie's Syndrome]])
	*[[Volvulus]]		*[[Special:MyLanguage/Volvulus\|Volvulus]]


	==Clinical Features==		==Clinical Features==
	*[[Abdominal pain]]
			*[[Special:MyLanguage/Abdominal pain\|Abdominal pain]]
	*Abdominal distension		*Abdominal distension
	**Distention is greater if the ileocecal valve is competent (it creates a closed loop obstruction). If the ileocecal valve is not competent, you are more likely to see some dilation of the small bowel as well <ref name="Radiology"> Jaffe T, Thompson WM. Large-Bowel Obstruction in the Adult: Classic Radiographic and CT Findings, Etiology, and Mimics. Radiology. 2015; 275(3):651-663 </ref>		**Distention is greater if the ileocecal valve is competent (it creates a closed loop obstruction). If the ileocecal valve is not competent, you are more likely to see some dilation of the small bowel as well <ref name="Radiology"> Jaffe T, Thompson WM. Large-Bowel Obstruction in the Adult: Classic Radiographic and CT Findings, Etiology, and Mimics. Radiology. 2015; 275(3):651-663 </ref>
	*Obstipation		*Obstipation
	*[[Vomiting]]		*[[Special:MyLanguage/Vomiting\|Vomiting]]
	*Palpable abdominal mass (could be distended bowel or could be tumor causing obstruction)		*Palpable abdominal mass (could be distended bowel or could be tumor causing obstruction)
	*[[Fever]] and [[tachycardia]] should prompt investigation for gangrene and perforation		*[[Special:MyLanguage/Fever\|Fever]] and [[Special:MyLanguage/tachycardia\|tachycardia]] should prompt investigation for gangrene and perforation


	==Differential Diagnosis==		==Differential Diagnosis==

			</translate>
	{{Abdominal Pain DDX Diffuse‎}}		{{Abdominal Pain DDX Diffuse‎}}
			<translate>


	==Evaluation==		==Evaluation==

	[[File:LargeBowelObsUp2008.jpg\|thumb\|Upright abdominal X-ray of a person with a large bowel obstruction showing multiple air fluid levels and dilated loops of bowel.]]		[[File:LargeBowelObsUp2008.jpg\|thumb\|Upright abdominal X-ray of a person with a large bowel obstruction showing multiple air fluid levels and dilated loops of bowel.]]
	[[File:Cecalvolvulus.png\|\|thumb\|Large bowel obstruction (Cecal [[volvulus]]; black arrows).]]		[[File:Cecalvolvulus.png\|\|thumb\|Large bowel obstruction (Cecal [[Special:MyLanguage/volvulus\|volvulus]]; black arrows).]]
	*Labs		*Labs
	**None are diagnostic		**None are diagnostic
	**Check electrolytes to assess for [[dehydration]]		**Check electrolytes to assess for [[Special:MyLanguage/dehydration\|dehydration]]
	**[[Leukocytosis]] could indicate gangrene or perforation		**[[Special:MyLanguage/Leukocytosis\|Leukocytosis]] could indicate gangrene or perforation
	**[[Anemia]] could indicate malignancy as source of obstruction		**[[Special:MyLanguage/Anemia\|Anemia]] could indicate malignancy as source of obstruction
	**[[ABG]] may help assess if the patient has respiratory compromise from diaphragmatic compression <ref name="surgclinic"> Lopez-Kostner F, Hool GR, et al. Management and Causes of Acute Large-Bowel Obstruction.. Surgical Clinics of North America. 1997; 77(6); 1265-1290 </ref>		**[[Special:MyLanguage/ABG\|ABG]] may help assess if the patient has respiratory compromise from diaphragmatic compression <ref name="surgclinic"> Lopez-Kostner F, Hool GR, et al. Management and Causes of Acute Large-Bowel Obstruction.. Surgical Clinics of North America. 1997; 77(6); 1265-1290 </ref>
	*Imaging <ref name="radclinic"> Murphy K, Twomey M, McLaughlin P, et al. Imaging of Ischemia, Obstruction and Infection in the Abdomen. Radiology Clinics of North America. 2105; 53: 847-869 </ref>		*Imaging <ref name="radclinic"> Murphy K, Twomey M, McLaughlin P, et al. Imaging of Ischemia, Obstruction and Infection in the Abdomen. Radiology Clinics of North America. 2105; 53: 847-869 </ref>
	**Use the 3/6/9 rule for bowel imaging		**Use the 3/6/9 rule for bowel imaging
	***Upper limit of 3cm for small bowel, 6cm for colon, and 9cm for cecum		***Upper limit of 3cm for small bowel, 6cm for colon, and 9cm for cecum
	**[[KUB\|XR]]		**[[Special:MyLanguage/KUB\|XR]]
	***Sensitivity of 69% to 80% for detecting bowel obstruction, but insensitive for diagnosing cause or location		***Sensitivity of 69% to 80% for detecting bowel obstruction, but insensitive for diagnosing cause or location
	***Upright films can detect pneumoperitoneum, hollow viscus perforation		***Upright films can detect pneumoperitoneum, hollow viscus perforation
Línea 52:		Línea 66:
	**Colonoscopy		**Colonoscopy
	***Can be used to rule-out pseudo-obstruction in patients who are not candidates for urgent surgical intervention		***Can be used to rule-out pseudo-obstruction in patients who are not candidates for urgent surgical intervention


	==Management==		==Management==
	*[[IVF\|IV hydration]]
			*[[Special:MyLanguage/IVF\|IV hydration]]
	*NPO		*NPO
	*[[analgesia\|Pain management]]		*[[Special:MyLanguage/analgesia\|Pain management]]
	*Place [[NG tube\|NGT]] if patient has significant vomiting or evidence of small bowel distension		*Place [[Special:MyLanguage/NG tube\|NGT]] if patient has significant vomiting or evidence of small bowel distension
	*[[Antibiotics]] if gangrene or perforation is suspected (cover gram-negative and anaerobics)		*[[Special:MyLanguage/Antibiotics\|Antibiotics]] if gangrene or perforation is suspected (cover gram-negative and anaerobics)
	*Consult GI, surgery, IR as appropriate		*Consult GI, surgery, IR as appropriate


	===Treatment for specific etiologies===		===Treatment for specific etiologies===

	*Diverticular abscess: percutaneous drainage		*Diverticular abscess: percutaneous drainage
	*[[Volvulus]]: endoscopic decompression		*[[Special:MyLanguage/Volvulus\|Volvulus]]: endoscopic decompression
	*[[ogilvie's syndrome\|Pseudo-obstruction]]: endoscopic decompression		*[[Special:MyLanguage/ogilvie's syndrome\|Pseudo-obstruction]]: endoscopic decompression
	*[[Intussusception]]: surgical intervention		*[[Special:MyLanguage/Intussusception\|Intussusception]]: surgical intervention


	==Disposition==		==Disposition==

	*Admit		*Admit


	==See Also==		==See Also==
	*[[Small bowel obstruction]]
	*[[Ogilvie's syndrome]]		*[[Special:MyLanguage/Small bowel obstruction\|Small bowel obstruction]]
			*[[Special:MyLanguage/Ogilvie's syndrome\|Ogilvie's syndrome]]


	==References==		==References==

	<references/>		<references/>

	[[Category:GI]]		[[Category:GI]]
			</translate>

Rossdonaldson1: /* Background */

2022-04-23T11:39:42Z

Background

← Revisión anterior		Revisión del 11:39 23 abr 2022
Línea 1:		Línea 1:
	==Background==		==Background==
			[[File:Diameters of the large intestine.png\|thumb\|Average inner diameters and ranges of different sections of the large intestine.<ref> Nguyen H, Loustaunau C, Facista A, Ramsey L, Hassounah N, Taylor H, et al. (July 2010). "Deficient Pms2, ERCC1, Ku86, CcOI in field defects during progression to colon cancer". Journal of Visualized Experiments (41). doi:10.3791/1931. PMC 3149991. PMID 20689513.</ref>]]
	*Much less common than [[SBO]], but more ominous (frequently associated with malignancy)		*Much less common than [[SBO]], but more ominous (frequently associated with malignancy)
	**LBO more common in elderly, and generally has more insidious onset than SBO		**LBO more common in elderly, and generally has more insidious onset than SBO

Rossdonaldson1: /* Evaluation */

2021-07-07T22:40:01Z

Evaluation

← Revisión anterior		Revisión del 22:40 7 jul 2021
Línea 29:		Línea 29:
	==Evaluation==		==Evaluation==
	[[File:LargeBowelObsUp2008.jpg\|thumb\|Upright abdominal X-ray of a person with a large bowel obstruction showing multiple air fluid levels and dilated loops of bowel.]]		[[File:LargeBowelObsUp2008.jpg\|thumb\|Upright abdominal X-ray of a person with a large bowel obstruction showing multiple air fluid levels and dilated loops of bowel.]]
			[[File:Cecalvolvulus.png\|\|thumb\|Large bowel obstruction (Cecal [[volvulus]]; black arrows).]]
	*Labs		*Labs
	**None are diagnostic		**None are diagnostic

Rossdonaldson1: /* Evaluation */

2021-07-07T22:35:58Z

Evaluation

← Revisión anterior		Revisión del 22:35 7 jul 2021
Línea 28:		Línea 28:

	==Evaluation==		==Evaluation==
			[[File:LargeBowelObsUp2008.jpg\|thumb\|Upright abdominal X-ray of a person with a large bowel obstruction showing multiple air fluid levels and dilated loops of bowel.]]
	*Labs		*Labs
	**None are diagnostic		**None are diagnostic

Elcatracho: /* Causes */

2021-02-10T18:34:43Z

Causes

← Revisión anterior		Revisión del 18:34 10 feb 2021
Línea 6:		Línea 6:

	===Causes===		===Causes===
			*Neoplasm (most common cause)
	*Adhesions		*Adhesions
	*[[Diverticulitis\|Diverticular disease]]		*[[Diverticulitis\|Diverticular disease]]
	*[[Fecal impaction]]		*[[Fecal impaction]]
	*[[Hernia\|Hernias]]		*[[Hernia\|Hernias]]
	*Neoplasm
	*Strictures		*Strictures
	*Pseudo-obstruction (e.g. [[Ogilvie's Syndrome]])		*Pseudo-obstruction (e.g. [[Ogilvie's Syndrome]])

Elcatracho: /* Evaluation */

2021-01-15T03:02:52Z

Evaluation

← Revisión anterior		Revisión del 03:02 15 ene 2021
Línea 36:		Línea 36:
	*Imaging <ref name="radclinic"> Murphy K, Twomey M, McLaughlin P, et al. Imaging of Ischemia, Obstruction and Infection in the Abdomen. Radiology Clinics of North America. 2105; 53: 847-869 </ref>		*Imaging <ref name="radclinic"> Murphy K, Twomey M, McLaughlin P, et al. Imaging of Ischemia, Obstruction and Infection in the Abdomen. Radiology Clinics of North America. 2105; 53: 847-869 </ref>
	**Use the 3/6/9 rule for bowel imaging		**Use the 3/6/9 rule for bowel imaging
	*Upper limit of 3cm for small bowel, 6cm for colon, and 9cm for cecum[[KUB\|XR]]		***Upper limit of 3cm for small bowel, 6cm for colon, and 9cm for cecum
			**[[KUB\|XR]]
	***Sensitivity of 69% to 80% for detecting bowel obstruction, but insensitive for diagnosing cause or location		***Sensitivity of 69% to 80% for detecting bowel obstruction, but insensitive for diagnosing cause or location
	***Upright films can detect pneumoperitoneum, hollow viscus perforation		***Upright films can detect pneumoperitoneum, hollow viscus perforation

Elcatracho: /* Evaluation */

2021-01-15T03:02:31Z

Evaluation

← Revisión anterior		Revisión del 03:02 15 ene 2021
Línea 35:		Línea 35:
	**[[ABG]] may help assess if the patient has respiratory compromise from diaphragmatic compression <ref name="surgclinic"> Lopez-Kostner F, Hool GR, et al. Management and Causes of Acute Large-Bowel Obstruction.. Surgical Clinics of North America. 1997; 77(6); 1265-1290 </ref>		**[[ABG]] may help assess if the patient has respiratory compromise from diaphragmatic compression <ref name="surgclinic"> Lopez-Kostner F, Hool GR, et al. Management and Causes of Acute Large-Bowel Obstruction.. Surgical Clinics of North America. 1997; 77(6); 1265-1290 </ref>
	*Imaging <ref name="radclinic"> Murphy K, Twomey M, McLaughlin P, et al. Imaging of Ischemia, Obstruction and Infection in the Abdomen. Radiology Clinics of North America. 2105; 53: 847-869 </ref>		*Imaging <ref name="radclinic"> Murphy K, Twomey M, McLaughlin P, et al. Imaging of Ischemia, Obstruction and Infection in the Abdomen. Radiology Clinics of North America. 2105; 53: 847-869 </ref>
	**[[KUB\|XR]]		**Use the 3/6/9 rule for bowel imaging
			*Upper limit of 3cm for small bowel, 6cm for colon, and 9cm for cecum[[KUB\|XR]]
	***Sensitivity of 69% to 80% for detecting bowel obstruction, but insensitive for diagnosing cause or location		***Sensitivity of 69% to 80% for detecting bowel obstruction, but insensitive for diagnosing cause or location
	***Upright films can detect pneumoperitoneum, hollow viscus perforation		***Upright films can detect pneumoperitoneum, hollow viscus perforation

ClaireLewis at 22:53, 29 September 2019

2019-09-29T22:53:39Z

← Revisión anterior		Revisión del 22:53 29 sep 2019
Línea 30:		Línea 30:
	*Labs		*Labs
	**None are diagnostic		**None are diagnostic
	**Check electrolytes to assess for dehydration		**Check electrolytes to assess for [[dehydration]]
	**[[Leukocytosis]] could indicate gangrene or perforation		**[[Leukocytosis]] could indicate gangrene or perforation
	**[[Anemia]] could indicate malignancy as source of obstruction		**[[Anemia]] could indicate malignancy as source of obstruction
	**ABG may help assess if the patient has respiratory compromise from diaphragmatic compression <ref name="surgclinic"> Lopez-Kostner F, Hool GR, et al. Management and Causes of Acute Large-Bowel Obstruction.. Surgical Clinics of North America. 1997; 77(6); 1265-1290 </ref>		**[[ABG]] may help assess if the patient has respiratory compromise from diaphragmatic compression <ref name="surgclinic"> Lopez-Kostner F, Hool GR, et al. Management and Causes of Acute Large-Bowel Obstruction.. Surgical Clinics of North America. 1997; 77(6); 1265-1290 </ref>
	*Imaging <ref name="radclinic"> Murphy K, Twomey M, McLaughlin P, et al. Imaging of Ischemia, Obstruction and Infection in the Abdomen. Radiology Clinics of North America. 2105; 53: 847-869 </ref>		*Imaging <ref name="radclinic"> Murphy K, Twomey M, McLaughlin P, et al. Imaging of Ischemia, Obstruction and Infection in the Abdomen. Radiology Clinics of North America. 2105; 53: 847-869 </ref>
	**XR		**[[KUB\|XR]]
	***Sensitivity of 69% to 80% for detecting bowel obstruction, but insensitive for diagnosing cause or location		***Sensitivity of 69% to 80% for detecting bowel obstruction, but insensitive for diagnosing cause or location
	***Upright films can detect pneumoperitoneum, hollow viscus perforation		***Upright films can detect pneumoperitoneum, hollow viscus perforation
Línea 49:		Línea 49:

	==Management==		==Management==
	*IV hydration		*[[IVF\|IV hydration]]
	*NPO		*NPO
	*Pain management		*[[analgesia\|Pain management]]
	*Place NGT if patient has significant vomiting or evidence of small bowel distension		*Place [[NG tube\|NGT]] if patient has significant vomiting or evidence of small bowel distension
	*Antibiotics if gangrene or perforation is suspected (cover gram-negative and anaerobics)		*[[Antibiotics]] if gangrene or perforation is suspected (cover gram-negative and anaerobics)
	*Consult GI, surgery, IR as appropriate		*Consult GI, surgery, IR as appropriate

	===Treatment for specific etiologies===		===Treatment for specific etiologies===
	*Diverticular abscess: percutaneous drainage		*Diverticular abscess: percutaneous drainage
	*Volvulus: endoscopic decompression		*[[Volvulus]]: endoscopic decompression
	*Pseudo-obstruction: endoscopic decompression		*[[ogilvie's syndrome\|Pseudo-obstruction]]: endoscopic decompression
	*Intussusception: surgical intervention		*[[Intussusception]]: surgical intervention

	==Disposition==		==Disposition==

ClaireLewis at 21:33, 9 September 2019

2019-09-09T21:33:47Z

← Revisión anterior		Revisión del 21:33 9 sep 2019
Línea 1:		Línea 1:
	==Background==		==Background==
	*Much less common than SBO, but more ominous (frequently associated with malignancy)		*Much less common than [[SBO]], but more ominous (frequently associated with malignancy)
	**LBO more common in elderly, and generally has more insidious onset than SBO		**LBO more common in elderly, and generally has more insidious onset than SBO
	*Most commonly occurs in the left (descending) colon		*Most commonly occurs in the left (descending) colon
Línea 8:		Línea 8:
	*Adhesions		*Adhesions
	*[[Diverticulitis\|Diverticular disease]]		*[[Diverticulitis\|Diverticular disease]]
	*Fecal impaction		*[[Fecal impaction]]
	*[[Hernia\|Hernias]]		*[[Hernia\|Hernias]]
	*Neoplasm		*Neoplasm
Línea 16:		Línea 16:

	==Clinical Features==		==Clinical Features==
	*Abdominal pain		*[[Abdominal pain]]
	*Abdominal distension		*Abdominal distension
	**~~Distension~~ is greater if the ileocecal valve is competent (it creates a closed loop obstruction). If the ileocecal valve is not competent, you are more likely to see some dilation of the small bowel as well <ref name="Radiology"> Jaffe T, Thompson WM. Large-Bowel Obstruction in the Adult: Classic Radiographic and CT Findings, Etiology, and Mimics. Radiology. 2015; 275(3):651-663 </ref>		**Distention is greater if the ileocecal valve is competent (it creates a closed loop obstruction). If the ileocecal valve is not competent, you are more likely to see some dilation of the small bowel as well <ref name="Radiology"> Jaffe T, Thompson WM. Large-Bowel Obstruction in the Adult: Classic Radiographic and CT Findings, Etiology, and Mimics. Radiology. 2015; 275(3):651-663 </ref>
	*Obstipation		*Obstipation
	*Vomiting		*[[Vomiting]]
	*Palpable abdominal mass (could be distended bowel or could be tumor causing obstruction)		*Palpable abdominal mass (could be distended bowel or could be tumor causing obstruction)
	*Fever and tachycardia should prompt investigation for gangrene and perforation		*[[Fever]] and [[tachycardia]] should prompt investigation for gangrene and perforation

	==Differential Diagnosis==		==Differential Diagnosis==
Línea 31:		Línea 31:
	**None are diagnostic		**None are diagnostic
	**Check electrolytes to assess for dehydration		**Check electrolytes to assess for dehydration
	**Leukocytosis could indicate gangrene or perforation		**[[Leukocytosis]] could indicate gangrene or perforation
	**Anemia could indicate malignancy as source of obstruction		**[[Anemia]] could indicate malignancy as source of obstruction
	**ABG may help assess if the patient has respiratory compromise from diaphragmatic compression <ref name="surgclinic"> Lopez-Kostner F, Hool GR, et al. Management and Causes of Acute Large-Bowel Obstruction.. Surgical Clinics of North America. 1997; 77(6); 1265-1290 </ref>		**ABG may help assess if the patient has respiratory compromise from diaphragmatic compression <ref name="surgclinic"> Lopez-Kostner F, Hool GR, et al. Management and Causes of Acute Large-Bowel Obstruction.. Surgical Clinics of North America. 1997; 77(6); 1265-1290 </ref>
	*Imaging <ref name="radclinic"> Murphy K, Twomey M, McLaughlin P, et al. Imaging of Ischemia, Obstruction and Infection in the Abdomen. Radiology Clinics of North America. 2105; 53: 847-869 </ref>		*Imaging <ref name="radclinic"> Murphy K, Twomey M, McLaughlin P, et al. Imaging of Ischemia, Obstruction and Infection in the Abdomen. Radiology Clinics of North America. 2105; 53: 847-869 </ref>

Alvarez13 at 23:51, 21 November 2016

2016-11-21T23:51:02Z

← Revisión anterior		Revisión del 23:51 21 nov 2016
Línea 7:		Línea 7:
	===Causes===		===Causes===
	*Adhesions		*Adhesions
	*Diverticular disease		*[[Diverticulitis\|Diverticular disease]]
	*Fecal impaction		*Fecal impaction
	*Hernias		*[[Hernia\|Hernias]]
	*Neoplasm		*Neoplasm
	*Strictures		*Strictures
	*Pseudo-obstruction (Ogilvie's Syndrome)		*Pseudo-obstruction (e.g. [[Ogilvie's Syndrome]])
	*Volvulus		*[[Volvulus]]

	==Clinical Features==		==Clinical Features==