Large-Bowel Obstruction Differential Diagnoses

Updated: Dec 29, 2017
  • Author: Christy Hopkins, MD, MPH; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Diagnostic Considerations

Conditions that should be considered when evaluating a patient with large-bowel obstruction (LBO) include constipation, cecal or sigmoid volvulus, intussusception, intestinal perforation, acute colonic pseudo-obstruction (ACPO; Ogilvie syndrome), mesenteric and mesenteric artery ischemia. As noted earlier, incarcerated hernias are a frequently missed cause of bowel obstruction, particularly left-sided inguinal hernias in which colon obstruction occurs with the sigmoid colon incarcerated in the hernia. [14]

Suspect bowel perforation in patients with persistent unexplained tachycardia, fever, or abdominal pain. In addition, malignancy, such as colorectal carcinoma, should be considered for all patients who present with large-bowel obstruction.

Differential Diagnoses