Bowel obstruction natural history, complications and prognosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

If left untreated, 85% of patients with complete bowel obstruction may progress to develop ischemia, necrosis, and gangrene. Common complications of bowel obstruction include bowel ischemia, bowel perforation, gangrene and sepsis. Prognosis is generally excellent for non-ischemic bowel obstruction, and the mortality rate of patients with bowel obstruction is approximately 4 per 100,000. In contrast, prognosis for ischemic bowel obstruction is approximately 600 per 100,000.

Natural History, Complications, and Prognosis

Natural History

• The symptoms of bowel obstruction include nausea, vomiting, constipation and abdominal pain and commonly manifests acutely or can be chronic.
• If left untreated, 85% of patients with may progress to develop bowel ischemia, bowel necrosis, and sepsis.

Complications

• Common complications of bowel obstruction include:
  • Bowel ischemia
  • Bowel perforation
  • Gangrene
  • Sepsis
    • Mostly, with gram negative organisms such as E.coli
  • Dehydration
  • Electrolyte imbalance
    • Mostly hypokalemia and alkalosis
  • Kidney failure
  • Intra-abdominal abscess
  • Short bowel syndrome
    • A malabsorption disorder

Prognosis

• Prognosis is generally excellent for non-ischemic bowel obstruction, and the mortality rate of patients with bowel obstruction is approximately 4 per 100,000.
• In contrast, prognosis for ischemic bowel obstruction is approximately 60 per 100,000.

References

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