ABSTRACT
Intravenous hydration and nasogastric suction will fail to control the symptoms of inoperable bowel obstruction in approximately 90% of patients. Medical management will keep the majority of patients free of nausea and pain, achieving a comfortable phase with the option of doing this at home. Recurrent abdominal cancer causes multiple blockages, especially with small bowel blockage in ovarian carcinoma. Absent motility or abnormal bowel motility can cause obstructive symptoms. Dysmotility is common in cancer and can be caused by retroperitoneal disease, antimuscarinic drugs or autonomic failure. Benign adhesions may occur in up to 20% of patients with recurrent abdominal cancer, and are the commonest cause of small bowel obstruction. Nasogastric suction or drainage has a place in feculant or fecal vomiting. Feculant vomiting is not the vomiting of feces, but of small bowel contents colonized by colonic bacteria in obstructions lasting a week or more.
