Large bowel obstruction

Large bowel obstruction-most common causes related to malignancy, volvulus, hernia, diverticular disease, inflammatory bowel disease, strictures, intussusception, and fecal impaction.

Adhesions a rare cause.

In neonates and children differential diagnosis includes Hirschsprung’s disease.

Bowel obstruction is the key findings in significant number of surgical abdomens., accounting for 20% of all cases.

Large bowel obstructions account for 20 to 25% of cases of bowel obstruction.

Neoplasms makes up 60% of cases of large bowel bowel obstructions and other causes include diverticulitis 20%, volvulus 5%, intussusception, inflammatory bowel disease, congenital megacolon, and fecal impaction/obstipation as less frequent causes.

Colon cancer most commonly causes large bowel obstruction that occurs in the left colon, as a result of the smaller lumen.

Less than one third of patients with colon cancer present with obstruction as a chief complaint.

Bowel obstruction caused by diverticulitis results from chronic inflammatory changes leading to hypertrophy of muscle and fibrosis causing stricture of the bowel.

Volvulus with bowel obstruction is primarily seen in the sigmoid colon and cecum and in institutionalized elderly patients who have chronic constipation.

Volvulus may also be present in women with obstruction in the third trimester of pregnancy.

Endometriosis is a rare cause of large intestinal obstruction.

Compared with obstruction of the small intestine, large bell obstruction presents with milder symptoms and progresses more insidiously.

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