Malignant bowel obstruction
Recognising malignant bowel obstruction, the CT and the surgical question, who benefits from surgery or a stent, the medical regimen without a nasogastric tube, venting gastrostomy, parenteral nutrition and the drugs to stop.
Tier 2Condition
Written with AI assistance and fact-checked against the sources below. For exam study, not clinical decisions. How notes are made
At a glance
- Malignant bowel obstruction (MBO) is obstruction beyond the ligament of Treitz in a patient with incurable intra-abdominal cancer, or extra-abdominal cancer with clear peritoneal spread (Anthony 2007 consensus definition).
- Commonest with ovarian (up to about 50% in advanced disease) and colorectal cancer. Median survival after diagnosis is weeks to a few months.
- CT defines the level and the number of sites. A single site in a fit patient prompts a surgical or stent opinion; multiple sites, ascites and poor performance status point to medical care.
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Sources
- Therapeutic Guidelines: Palliative Care (eTG complete), version 5AU/NZTherapeutic Guidelines Limited, 2024 (version 5, December 2024; no later update listed at November 2026)
- Davis M et al. Medical management of malignant bowel obstruction in patients with advanced cancer: 2021 MASCC guideline update. Support Care Cancer 2021;29:8089-8096Multinational Association of Supportive Care in Cancer, 2021 (current at November 2026)
- Madariaga A et al. MASCC multidisciplinary evidence-based recommendations for the management of malignant bowel obstruction in advanced cancer. Support Care Cancer 2022;30:4711-4728Multinational Association of Supportive Care in Cancer, 2022
- Krouse RS et al. Surgical versus non-surgical management for patients with malignant bowel obstruction (S1316): a pragmatic comparative effectiveness trial. Lancet Gastroenterol Hepatol 2023;8:908-918The Lancet Gastroenterology and Hepatology, 2023
- Currow DC et al. Double-blind, placebo-controlled, randomized trial of octreotide in malignant bowel obstruction. J Pain Symptom Manage 2015;49:814-821AU/NZJournal of Pain and Symptom Management, 2015
- Anthony T et al. Report of the clinical protocol committee: development of randomized trials for malignant bowel obstruction. J Pain Symptom Manage 2007;34(1 Suppl):S49-S59Journal of Pain and Symptom Management, 2007
- Last updated
- 14 November 2026
What changed
- 14 November 2026 Personal emails, About story and Australian-style copy