Large bowel obstruction refers to a medical emergency where the intestines' normal passage of food, fluids, and gas is impeded, requiring immediate medical intervention

Aetiology

Causes include:

• Colonic tumours
• Strictures, often secondary to diverticular disease, inflammatory bowel disease, or post-surgical anastomosis
• Volvulus, either sigmoid or caecal
• Hernias
• Adhesions

Clinical features

Symptoms

• Cramping abdominal pain
• Bloating
• Potential nausea and vomiting, though these are more common in small bowel obstruction and are considered late signs in large bowel obstruction

Signs

• Absolute constipation, characterized by an inability to pass wind or faeces

Investigations

• Abdominal X-ray: a primary tool for diagnosing large bowel obstruction
• CT abdomen: essential in identifying the cause (e.g., malignancy), as well as providing more details such as the transition point and distinguishing between caecal and sigmoid volvulus

Management

• Supportive care: encompasses analgesia, IV fluids, and anti-emetics