[Intestinal occlusion in cancer]

Abstract

Objective: To perform a review of the literature about the management of bowel obstruction in advanced cancer.

Background: Bowel obstruction is a common problem, mainly in patients with advanced colorectal or ovarian cancer. The management of this group of patients is complex and controversial.

Methods: A review of the English and Spanish literature about the clinical picture, diagnosis and management of bowel obstruction in advanced cancer was performed.

Results: Bowel obstruction is a common and distressing outcome in patients with abdominal or pelvic cancer. Patients may develop bowel obstruction at any time in their clinical history, with a prevalence ranking from 5.5 to 51% in those with ovarian cancer and from 10% to 28% in those with colorectal cancer. The causes of the obstruction may be benign postoperative adhesions, a focal malignant or benign deposit, or relapse or diffuse carcinomatosis. The symptoms, which are almost always present, are intestinal colic, continuous abdominal pain, nausea or vomiting. Although surgery should be the primary treatment for malignant obstruction, it is now recognized that some patients with advanced disease or in generally poor condition are unfit for surgery and require alternative management to relieve distressing symptoms. A number of treatment options are now available for the patient with advanced cancer who develops intestinal obstruction.

Conclusions: Bowel obstruction in cancer patients is a common and difficult problem. Patients must be selected for surgery or palliative treatment of their symptoms based on their clinical status.