ABSTRACT
This chapter is devoted to the urgent evaluation and if the patient with large bowel obstruction is extensive due to the numerous different types of possible aetiologies of large bowel obstruction. The patient with large bowel obstruction requires evaluation in an environment, which is a microcosm of massive number and style of changes in medical care in the 21st century. There is a growing number of very elderly patients, many of whom are also very frail. As with all of acute surgery, in evaluating the patient with acute large bowel obstruction, the surgeon must first evaluate the patient’s severity of illness, establish a differential diagnosis and then decide upon the priorities in safely treating the patient. In contrast to continental Europe and the UK, where magnetic resonance imaging is ubiquitous, in the United States, one literally cannot leave casualty unit without having undergone at least a Computed tomography of the abdomen and pelvis if one presents with an abdominal complaint.
