Intestinal obstruction in case of oncology
20th October 2018
In 60 to 70% of cases, bowel obstruction in cancer is caused by a tumour or its metastases, in 20 to 30% – by diseases of the gastrointestinal tract, in 10 to 20% – by a metachronous tumour, which is operable commonly. Intestinal obstruction is most often caused by such malignant neoplasms as ovarian cancer and gastrointestinal tract tumours.
Pathogenesis of intestinal obstruction in oncology:
- Compression of the intestine from the outside.
Obturation of the intestine from the inside.
Paralytic intestinal obstruction due to local or diffuse disruption of intestinal motility due to germination of the nerve plexus by a tumour.
Invagination of the intestine in some tumours, usually with melanoma.
- Pink periwinkle alkaloids cause constipation. Reduced bowel tone and paralytic intestinal obstruction, especially in the elderly, can lead to high faecal blockages and mechanical intestinal obstruction. It is easier to prevent faecal blockage than to heal.
Radiation enteritis in radiography and CT scan of the abdomen is manifested by smoothing the mucous membrane, ulcers, strictures, rigidity, adhesions and expansion of the intestine and thickening of its wall.
Diverticulitis is the cause of pronounced strictures of the distal colon, which are radiographically indistinguishable from exophytic cancer usually. In the absence of metastases, these areas are to be resected independently of a primary tumour.
Other non-tumour causes of intestinal obstruction include intestinal adhesions, intestinal hernias, chronic inflammatory bowel diseases, intestinal volvulus, spontaneous invagination of the intestines, acute pancreatitis and intestinal infarction.
Therapy in cases of intestinal obstruction due to cancer
Treatment of intestinal obstruction caused by a tumour:
- Intestinal decompression.
Surgery. A malignant tumour is not always a contraindication to surgery. Approximately 75% of patients after surgery restored normal bowel function. Intestinal obstruction no longer recurs in 45% of patients. However, about 25% of patients do not improve their condition after surgery.
The operation is advisable if the patient’s condition does not improve in 4-5 days after decompression of the gastrointestinal tract. Intestinal obstruction in oncology can also be treated with chemo-, radiation therapy and some other methods. Colonic Hydrotherapy will also help cleanse the intestines from waste and toxins accumulated in it