Large Bowel Obstruction in the Emergency Department: Imaging Spectrum of Common and Uncommon Causes

Although large bowel obstruction (LBO) is less common than small bowel obstruction, it is associated with high morbidity and mortality due to delayed diagnosis and/or treatment. Plain radiographs are sufficient to diagnose LBO in a majority of patients.

 The Sick Bowel Obstruction Patient

Bowel obstructions may present along a spectrum and can pose a diagnostic challenge, with early or low grade obstruction manifesting with non-specific symptoms and a non-focal exam in a relatively well appearing patient. Others are more obvious with classic symptoms of abdominal distention, feculent belching or emesis, significant pain, and decreased to no bowel movements/flatus. Presentation will also vary depending on the location of the obstruction (proximal versus distal).

Bowel Blockage or Obstruction

About 20% of people admitted to hospital with an acute abdomen (or an abdomen that quickly becomes firm, is tender to touch and painful), have an obstruction of their bowel. Of these 20%, the majority (80%) will have a small bowel obstruction.

Bowel obstruction

Bowel obstruction is a common surgical presentation. It can be categorised into small and large bowel obstruction, with key implications for management.

Bowel Obstruction (Diagnosis + Treatment)

Plain abdominal radiography is the initial imaging modality of choice to rapidly confirm the diagnosis, followed by contrast-enhanced CT of the abdomen and pelvis to further characterize the obstruction (provided the plain films do not have findings that indicate the need for immediate intervention).

Bowel obstruction: a narrative review for all physicians

In 90% of cases, small bowel obstruction is caused by adhesions, hernias, and neoplasms. Adhesive small bowel obstruction represents 55–75% of small bowel obstruction cases while hernias and small bowel tumors account for the remainder. Large bowel obstruction is provoked by cancer in about 60% of cases; volvulus and diverticular disease are responsible of other 30%.

Failure in care means bowel surgery patients are dying unnecessarily

More than one in 10 (11%) of those having emergency bowel surgery die within 30 days, according to an audit of the treatment received by 21,000 patients at 192 hospitals in England and Wales. But the death rate is higher than it should be because of the widespread failure of hospitals to ensure that patients whose lives are under threat – from vital organ failure and an obstructed bowel caused by cancer – get the right care before, during and after their o

Girl's Abdominal Blockage Reportedly Caused by Hundreds of Undigested Boba Pearls

Oh cool, just the nightmare we needed today.

Intern Ultrasound of the Month: Small (& Large) Bowel Obstruction

Most common underlying cause is adhesions from a prior abdominal surgery, accounting for 60-75% of cases. This is followed by colonic neoplasm, hernia, IBD, volvulus.

Swallowing Tiny Magnets Can Lead To Big Trouble For Kids

Most of the incidents involve young children, but there was also a rise among older ones, including teens. But why the uptick in magnets being swallowed by teens? Shouldn't they know better? It turns out they're not gobbling magnets like younger kids. Instead, she says, they're mostly using them to mimic body piercings, like, say, a nose or tongue stud. And while these older kids are out looking cool, sometimes those little round magnets come loose. Next thing you know they're in the stomach or lower. Definitely not cool.

The Big Bowel Incident and Little Ms. Oberon

Most people think of diverticulitis or cancerous polyps growing inside the intestinal walls, as causing the bowel obstruction. However, Dr. Richard A. Desi, MD, a gastroenterologist at Mercy Medical Center in Baltimore says, “A bowel obstruction is not really anything on the inside of the bowel.” He explains that most commonly, bowel obstruction can twist “the bowel into a funny position, thus closing it or clamping it off.”

Twisted Bowels- All about Bowel obstructions, both large and small

They make up 2-4% of emergency department visits annually in the US, and 15% of hospital admissions.