Intestinal obstruction in advanced malignant disease

Abstract

Intestinal obstruction is a complication of advanced malignancy, with an incidence of up to 15% according to data from palliative care units. The clinical picture is similar to that observed in cases of non-malignant cause. Surgery still is the preferred treatment for this condition. However, the surgical decision depends on various factors, mainly the patients general health status. Patients are often debilitated or even cachectic, in the terminal phase of their disease, thus presenting with a higher surgical risk. The patients and the familys wishes are also important when making a decision. Whenever surgery is not an option, the patient should be treated conservatively according to his/her symptoms. Abdominal pain, nausea and vomiting have been treated successfully. Results obtained with analgesics, anti-emetics, and other drugs, have allowed other forms of invasive therapy, such as prolonged nasogastric intubation or IV infusions, to seldom be required in palliative care. Thus, fluid ingestion and in some cases even a light meal are possible.