Malignant Bowel Obstruction - What are the options

Abstract

Title. Malignant bowel obstruction - what are the options Introduction. Malignant bowel obstruction is a  complication of patients with advanced intra-abdominal and pelvic malignancy with a prevalence of 3-5. Most often in view of the advanced nature of this disease these patients are either not treated or treated conservatively. Nutrition is a  major factor in improving the life expectancy and the quality of life in these patients. If obstruction is mechanical in nature then surgical treatment should be considered as it is proven to be beneficial in 90 of the times. Case description. We  present a 62 year old female with diabetes mellitus, hypertension and rheumatic heart disease who had left MRM for carcinoma breast in 2002, mitral valve replacement,  permanent pace maker placement for RHD in 2009, and TAH, BSO and pelvic nodal dissection for ovarian carcinoma in 2010. She also received 12 cycles chemotherapy following the last operation. She at present came with malignant bowel obstruction with disseminated intra-abdominal malignancy. We relieved her symptoms surgically by doing right   hemicolectomy and ileo-transverse anastomosis despite the disseminated disease and multiple co-morbid illnesses.   Discussion. Malignant bowel obstruction can be due to  functional or mechanical cause. If mechanical in nature then surgical correction is the mainstay of treatment provided the benefit outweighs the risks involved. However this may not be feasible in every patient and in such conditions endo-luminal palliation or pharmacological palliation is to be considered. Restoration of nutrition and there by improving the quality of life and life expectancy should be the ultimate goal.