الفهرس 
ANATOMYOnly 14 pages are availabe for public view
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Abstract
The aetiolgy and incidence rate of the large bowel obstruction are changed dramatically in 20th century, which characterized by decrease its frequency due to early diagnosis and management of most surgical abdominal diseases.
Large bowel obstruction is representing 20% of intestinal obstruction. Acute type is representing 25% of large bowel obstruction. from these ratio non–malignant causes represents 20%.
Mortality and morbidity are substantial. Mortality rate ranges from 3% in simple obstruction to 30% in perforated/obstructed cases depending on the clinical setting and other co-morbidities. Recurrence rate vary according to method of management.
There is a wide variety in the frequency and aetiology of the large bowel obstruction throughout the world depending on sex, age, family history, geographical distribution and race.
Most common presentations of the large bowel obstruction (LBO)- especially acute presentation- are acute abdominal pain and tenderness (80%), nausea/vomiting (60%) with distention and conistipation (60%) and systemic illness.
Diagnosis is depending mainly on clinical history and examination at time of presentation, diagnostic measures as radiology and adjuvant specific measures as sigmoidoscopy or colonoscopy, which are diagnostic in cases of doubt or discovering the cause of obstruction. The diagnostic measures depend on the quality and resources of health services in different hospitals, which vary throughout the world, so exploration (Urgent Laparotomy) is the real and most accurate diagnostic measure in diagnosis of acute large bowel obstruction especially in 3rd world Countries.
Treating patients with large bowel obstruction (LBO) requires careful assessment, through knowledge of possible causes, comprehensive awareness of the current treatments, and significant operative skill. Recently, a number of changes in (LBO) management have occurred, including a tendency toward resection and primary anastomosis after intraoperative colonic lavage. New operative strategies are available for treating volvulus, as new techniques to decompress the colon before definitive surgical treatment.