ØEpidemiology
üOccurs in 10-28% of patients with advanced intra-abdominal cancers, especially ovarian, colorectal, gastric, and pancreatic.
üOften indicates disease progression or peritoneal carcinomatosis.
ü
ØClinical Presentation
üNausea, vomiting, abdominal distension, colicky pain, and absence of bowel movement/flatus.
May progress to dehydration, electrolyte imbalance, and perforation risk
ØManagement
üImmediate measures:NPO, IV fluids, and nasogastric decompression
üImaging: Abdomino-Pelvic CT with contrast for obstruction point/level evaluation
üDefinitive / Palliative therapy:
•
Endoscopic stent (esophageal, gastric outlet, rectosigmoid) if feasible.
•
Venting gastrostomy for refractory vomiting
•
Surgery only for selected, fit patients, with single-level obstruction.
