Potentially life-threatening emergency
Large bowel obstruction
Alerts and Notices
Synopsis
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
- Colonic tumor / colon cancer
- Bowel adhesions
- Colonic volvulus
- Abdominal hernias
- Acute appendicitis
- Colonic polyps
- Diverticulitis
- Pseudomembranous colitis
- Clostridium difficile colitis
- Toxic megacolon
- Infectious colitis (eg, amebic colitis)
- Small bowel obstruction
- Ileus
- Pseudo-obstruction (Ogilvie syndrome)
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.Subscription Required
References
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Last Reviewed: 04/20/2017
Last Updated: 10/03/2018
Last Updated: 10/03/2018
Potentially life-threatening emergency
Large bowel obstruction
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