Proportion of colonic carcinoma in cases presenting with acute intestinal obstruction: a cross sectional study


  • Pauly T. Joseph Department of General surgery, Government medical college, Thrissur, Kerala, India
  • Rajiv Sajan Thomas Department of General surgery, Government medical college, Thrissur, Kerala, India
  • Sutharjivel V. Department of General surgery, Government medical college, Thrissur, Kerala, India



Acute intestinal obstruction, Colonic carcinoma, Obstructed hernia


Background: Acute intestinal obstruction is one of the most common emergencies encountered by the general surgeon in routine practice. Although historically, obstructed hernia has been the most common cause, recent studies have shown that adhesive intestinal obstruction is now the commonest reason. Malignant bowel obstruction is also on the rise especially with the change in dietary habits. This study aims at identifying the proportion of colonic carcinoma in cases presenting with acute intestinal obstruction.

Methods: The patients with acute intestinal obstruction which was diagnosed clinically and radiologically were studied. Based on operative and clinical findings along with investigation results, the etiology was identified. The patients having colonic neoplasms were identified and the data was compared with other etiological factors to find out the proportion of colonic carcinoma in the cases.

Results: The proportion of colon cancer in patients presenting with acute intestinal obstruction was around 15%. The most common cause was obstructed hernia followed by post-operative adhesions. Males were more commonly affected than females. Most of the cases underwent operative management. The most common age group affected was around 50-60 years.

Conclusions: This study confirms that there is a definite rise in the number of cases of colon cancer presenting as acute intestinal obstruction. There is also a skewing of the age at presentation towards younger age groups. Small bowel obstructions were much more common mainly due to adhesions and obstructed herniae.  


Fischer JE, Nusbain MS. Principle of Surgery. 7th ed. New York: McGraw Hill International Editions. 1999.

Akcakaya A, Alimoglu O, Hevenk T. Mechanical intestinal obstruction caused by abdominal wall hernias. Ulus Travma Derg. 2000;6(4):260-6.

McEntee G, Pender D, Mulvin D. Current spectrum of intestinal obstruction. Br J Surg. 1987;74(11):976-80.

Botterill ID, Sagar PM. Intestinal obstruction. Surgery. 1998;16:221-7.

Bailey H. Demonstrations of physical signs in clinical surgery. Academic Medicine. 1960;35(12):1185.

DeBernardo R. Surgical management of malignant bowel obstruction: strategies toward palliation of patients with advanced cancer. Current oncology reports. 2009;11(4):287-92.

Feuer DJ, Broadley KE, Shepherd JH, Barton DP. Systematic review of surgery in malignant bowel obstruction in advanced gynecological and gastrointestinal cancer. Gynecologic oncology. 1999;75(3):313-22.

Phillips RKS, Hittinger R, Fry JS, Fielding LP. Malignant large bowel obstruction.British Journal of Surgery. 1985;72(4):296-302.

Deans GT, Krukowski ZH, Irwin ST. Malignant obstruction of the left colon. British Journal of Surgery. 1994;81(9):1270-6.

U.S. Preventive Services Task Force. Colon cancer screening (USPSTF recommendation). J Am Geriatric Soc. 2000;48(3):333-5.

Moran BJ. Adhesion‐related small bowel obstruction. Colorectal Disease. 2007;9:39-44.

Chen XZ, Wei T, Jiang K, Yang K, Zhang B, Chen ZX et al. Etiological factors and mortality of acute intestinal obstruction: a review of 705 cases. Journal of Chinese integrative medicine. 2008;6(10):1010-6.

Hasnain SQ, Ahmed M. Intestinal obstruction in adults at the Aga Khan University Hospital. Journal Pakistan Medical Association. 1994;44:143.

Souvik A, Hossein MZ, Amitabha D, Nilanjan M, Udipta R. Etiology and outcome of acute intestinal obstruction: A review of 367 patients in Eastern India. Saudi journal of gastroenterology: official journal of the Saudi Gastroenterology Association. 2010;16(4):285.

Cole GJ. A review of 436 cases of intestinal obstruction in Ibadan. Gut. 1965;6(2):151.

Singh H. Acute intestinal obstruction. Arch Surg. 1965;91:389-92.

Pillai V, Benjamin RK, Chisthi MM. A Pattern of Intestinal Obstruction Cases–A Tertiary Care Centre Study. Annals of International Medical and Dental Research. 2004;3(2).

Khan JS, Alam J, Hassan H, Iqbal M. Pattern of intestinal obstruction a hospital based study. Pakistan Armed Forces Medical Journal. 2007;57(4):295-9.






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