ABSTRACT
Barium enema can be a useful adjunct at time of diagnosis in stable patients, as it can provide additional information regarding the size and tortuosity of obstructing lesions. Much of the literature surrounding the treatment approaches for large bowel obstructions (LBO) not only seeks to identify the ideal operative approach, but also the ideal timing of surgery and whether nonoperative bridging methods can help avoid emergent operations and improve outcomes. Ascending colon obstructions are less common given the larger diameter of the colon, but often present with higher tumor burden and more advanced disease in setting of colorectal malignancies. The largest prospective multicenter trial to date assessing safety and effectiveness of SEMs in the bridging treatment of malignant LBOs found high rates of successful stent deployment and effective decompression, resulting in 98% of their subjects receiving eventual elective surgery with minimal intervention-associated morbidity.
