LBO

Q; 75 years old male is admitted to ICU with severe abdominal pain and is found to have large bowel obstruction due to a tumor formation. Which of the following sites is more prone to have large bowel obstruction? - select one

A) hepatic flexure (Right)

B) splenic flexure (Left)

Answer: B

One-fourth of the bowel obstructions are caused by large bowel obstruction (LBO), and three-fourths by small bowel obstruction (SBO). LBO is more common in elderly people at or above age 70.

One of the most common cause of large bowel obstruction is colon cancer, and in about one-third of the cases, it can be a leading presentation.

Most LBOs occur at or distal to the transverse colon, as the colonic lumen is narrowing there. The most common site of obstructing colorectal cancer is the sigmoid colon. Tumors at the splenic flexure are more likely to obstruct than tumors at the hepatic flexure.

#surgical-critical-care

#oncology

#GI

References:

1. Aslar AK, Ozdemir S, Mahmoudi H, Kuzu MA. Analysis of 230 cases of emergent surgery for obstructing colon cancer--lessons learned. J Gastrointest Surg 2011; 15:110.

2. Biondo S, Parés D, Frago R, et al. Large bowel obstruction: predictive factors for postoperative mortality. Dis Colon Rectum 2004; 47:1889.

3. Frago R, Ramirez E, Millan M, et al. Current management of acute malignant large bowel obstruction: a systematic review. Am J Surg 2014; 207:127.