Malignant mass bowel obstruction: Case report and literature review

Dominykas Markevičius1

1Faculty of Medicine, Vilnius University, Vilnius, Lithuania.


Introduction: Malignant bowel obstruction is a frequent complication occurring in advanced abdominal or women urogenital system cancer patients. This complication can be resolved using either surgical or palliative treatment. We are putting forward a clinical case, which involves a 46-year-old patient, who got administered to the hospital due to general weakness, nausea, vomiting, abdominal pain, and inability to defecate.

Clinical case: A 46-year-old male was admitted with weakness, nausea, abdominal pain, bloating and no sensation to defecate, lasting for 5 days. Ultrasound showed that the small intestines had broader loops and the inside was covered with fluids. Small bowel obstruction was diagnosed, and Ringer lactate 1000 ml, nasogastric decompression, enema, and analgesics were administered. This conservative method was not effective. A month ago, a magnetic tomography imaging was performed and showed a mass, infiltrating the rectum, sigmoid colon, and pelvic muscles, also deforming the penis and perineum, and destroying the pubic bones, a paraaortic and inguinal lymphadenopathy. Since the radical surgery was not indicated due to the cancerous spreading and conservative treatment had no effect, a colostomy formation was performed. The second day after the surgery, the patient could drink and eat liquid food. During observation, the colostomy was functioning well.

Conclusion: Ileus is a condition, requiring an adequate and clinically thoughtful treatment. Restoration of the permeability or eradication of the occlusion due to the oncological process should be taken into consideration when treating patients. The main goal of the treatment is to bring back the quality and prolong the lifetime of the patient, so the least physically and psychologically discomforting treatment should be chosen.   

Key words: malignant bowel obstruction, ileus, abdominal pain.