Bowel obstruction occurs when there is reduced or absent progress of the forward flow of gastric and intestinal contents through the gastrointestinal tract

Pathophysiology

• Patients with disseminated intra-abdominal cancers are at risk
• Classically occurs with ovarian/peritoneal cancers
• Other cancers include - colon cancer, some breast cancers (particularly lobular), large cervical/uterine cancers
• ‘Omental cake’ - refers to infiltration of the omental fat by material of soft tissue density

Clinical features

• Abdominal pain
• Vomiting
• Bloating
• No bowel movement
• Assess for signs of intra-abdominal infection

Investigations

• AXR
• CXR
• CT abdo and pelvis

Management

Medical

• Decompression and bowel rest (NG tube)
• IV fluids and electrolytes