Management of Large Bowel Obstruction

Large bowel obstruction (LBO) can occur due to both benign and malignant diseases and may present with acute or indolent onset of symptoms. In patients with a perforation, emergent surgery should be pursued and will usually involve a segmental or subtotal colectomy with an ileostomy. In patients without these signs, and for whom the diagnosis is unclear, contrast enemas, CT scans, and endoscopy are useful in determining the etiology and severity of the obstruction. Management of LBO is dependent upon the underlying etiology and may include supportive measures, endoscopic interventions (with or without the placement of colonic stents), or surgical resection.