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Potentially life-threatening emergency
Large bowel obstruction
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Potentially life-threatening emergency

Large bowel obstruction

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Contributors: Michael W. Winter MD, Nishant H. Patel MD, Desiree Rivera-Nieves MD, Khaled Bittar MD
Other Resources UpToDate PubMed

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Synopsis

A large bowel obstruction refers to an obstruction of the large intestine resulting in proximal bowel dilatation and inability of stool or gas to pass distal to the level of obstruction. Large bowel tumors are most commonly caused by compressive malignancies. Adhesions, volvulus, strictures, or incarcerated hernias can also lead to obstruction of the large intestine.

Patients present with abdominal pain and the inability to move bowels or pass flatus, and occasionally nausea with emesis.

Unlike small bowel obstructions, large bowel obstructions have a higher likelihood of occurring in the setting of colorectal malignancies. Therefore, patients with strong family history of colorectal cancer and overdue surveillance or a known history of colorectal cancer should be considered higher risk for presenting with large bowel obstructions. Prior abdominal surgery with adhesion formation and chronic large bowel inflammation with stricture formation (eg, from ischemia, inflammatory bowel disease, recurrent diverticulitis) can also predispose a patient to developing a large bowel obstruction.

Marked dilatation of bowel loops and abrupt termination of gas within the descending colon is referred to as a colon cutoff sign.

Codes

ICD10CM:
K56.50 – Intestinal adhesions [bands], unspecified as to partial versus complete obstruction
K56.609 – Unspecified intestinal obstruction, unspecified as to partial versus complete obstruction

SNOMEDCT:
281254000 – Large bowel obstruction

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 04/20/2017
Last Updated: 10/03/2018
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Potentially life-threatening emergency
Large bowel obstruction
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View all Images (6)
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Large bowel obstruction : Abdominal pain, Nausea, Vomiting, Abdominal distension, Constipation, Tenesmus
Imaging Studies image of Large bowel obstruction
Coronal image from a CT scan demonstrating dilated ascending colon with large amount of stool. The remainder of the large bowel loops were also dilated, consistent with a large bowel obstruction.

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