Obstruction of large intestine (bowel)

Abdomen | Gastroenterology | Obstruction of large intestine (bowel) (Disease)


Obstruction of the large intestine (bowel obstruction)- Large-bowel obstruction (LBO) is an emergency condition that requires early identification and intervention. Obstruction may also be secondary to meconium ileus. In the pediatric population, Hirschsprung disease can resemble colonic obstruction. Hirschsprung disease is a developmental disorder of the enteric nervous system and is characterized by an absence of ganglion cells in the distal colon resulting in a functional obstruction. The challenges in managing this condition are distinguishing colonic obstruction from ileus, ruling out nonsurgical causes, and determining the best surgical management. Distinguishing between a true mechanical obstruction and a pseudo-obstruction is important, as the treatment differs.

Symptoms of large-bowel obstruction can include: a bloated abdomen, abdominal pain, which can be either vague and mild, or sharp and severe, depending on the cause of the obstruction, constipation at the time of obstruction, and possibly intermittent bouts of constipation for several months beforehand, if a colon tumor is the cause of the problem, a history of rectal bleeding (such as streaks of blood on the stool), diarrhea resulting from liquid stool leaking around a partial obstruction.

Causes and Risk factors

Causes of large bowel obstruction include: neoplasms, hernias, inflammatory bowel disease, colonic volvulus (sigmoid, caecal, transverse colon), constipation, fecal impaction, fecaloma, colon atresia, intestinal pseudoobstruction, benign strictures (diverticular disease), endometriosis.

Colonic obstruction is most common in elderly individuals, due to the higher incidence of neoplasms and other causative diseases in this population. In neonates, colonic obstruction may be caused by an imperforate anus or other anatomic abnormalities.

Diagnosis and Treatment

Treatment for intestinal obstruction depends on the cause of the condition. Treatment This may include: placing an intravenous (IV) line into a vein in the arm so that fluids can be given, putting a nasogastric (NG) tube through the nose and into the stomach to suck air and fluid out to relieve abdominal swelling, placing a thin, flexible tube (catheter) into the bladder to drain urine and collect it for testing.