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Large Bowel Obstruction

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General Surgery

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Pearls and Pitfalls

  • Differentiation of mechanical large bowel obstruction (LBO) from colonic pseudo-obstruction is crucial.

  • Colonoscopic examination is a beneficial diagnostic and potentially therapeutic modality.

  • The most frequent cause of LBO is colorectal cancer, and the most frequent site is the sigmoid colon followed by splenic flexure.

  • Volvulus of the sigmoid colon is the second most frequent cause of LBO and occurs most commonly in elderly, chronically constipated patients.

  • Timing, grading, site of obstruction, competency of the ileocecal valve, presence of ischemia or perforation, presence of locally advanced or metastatic disease, and operating skill influence the prognosis of patients and choice of the procedure.

  • Obstructing right colon cancer can be treated usually with primary resection and anastomosis; however, a protective ileostomy should be considered in selected patients.

  • Obstructing left colon cancer is more likely to necessitate resection with end colostomy; in...

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Selected Readings

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Author information

Authors and Affiliations

  1. São Paulo University Medical School, Rua Manoel da Nóbrega, 1564 São Paulo, 04002005, Ohio, Brazil

    Angelita Habr-Gama & Fábio Guilherme Campos

Authors
  1. Angelita Habr-Gama
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  2. Fábio Guilherme Campos
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Editor information

Editors and Affiliations

  1. Department of Surgery, Deputy Director, Comprehensive Cancer Center University of Alabama School of Medicine, Birmingham, AL, USA

    Kirby I. Bland MD (Fay Fletcher Kerner Professor and Chairman) (Fay Fletcher Kerner Professor and Chairman)

  2. Department of General and Visceral Surgery, University of Heidelberg, Heidelberg, Germany

    Markus W. Büchler MD (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

  3. Department of Surgery, University Hospital, Santiago, Chile

    Attila Csendes MD, FACS (Hon) (Professor of Surgery and Chairman) (Professor of Surgery and Chairman)

  4. James C. Mason Professor of Surgery Department of Surgery, Mayo Clinic College of Medicine, Rochester, MN, USA

    Michael G. Sarr MD

  5. Department of Clinical and Surgical Sciences, The University of Edinburgh Royal Infirmary of Edinburgh, Edinburgh, UK

    O. James Garden MBChB, MD, FRCS (Ed), FRCP (Ed), FRACS (Hon) (Regius Professor of Clinical Surgery) (Regius Professor of Clinical Surgery)

  6. Department of Surgery, The University of Hong Kong Queen Mary Hospital, Hong Kong, China

    John Wong BSc (Med (Syd)), MBBS (Syd), PhD (Syd), MD (Hon (Syd)), FRACS, FRCS (Edin), FRCS (Glasg), FACS (Hon) (Chair Professor) (Chair Professor)

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Habr-Gama, A., Campos, F.G. (2009). Large Bowel Obstruction. In: Bland, K.I., Büchler, M.W., Csendes, A., Sarr, M.G., Garden, O.J., Wong, J. (eds) General Surgery. Springer, London. https://doi.org/10.1007/978-1-84628-833-3_68

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  • DOI: https://doi.org/10.1007/978-1-84628-833-3_68

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-84628-832-6

  • Online ISBN: 978-1-84628-833-3

  • eBook Packages: MedicineReference Module Medicine

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