Prognosis

Large bowel obstruction from all causes is associated with appreciable mortality and morbidity owing to the nature of the disease process and the health of the patient groups affected.

Colonic volvulus

Data from the US Nationwide Inpatient Sample (2002-2010) suggest mortality rates of 9.4% and 6.6% following operative intervention (including resective procedures and operative detorsion with/without fixation procedures) for patients admitted emergently with sigmoid volvulus and caecal volvulus, respectively.[7] Retrospective studies report significant mortality (around 12% but can be up to 57% in some cases) following Hartmann's procedure for acute sigmoid volvulus.[9]​[59][60]

For decompression of sigmoid volvulus, without surgical treatment, single-centre studies report recurrence rates of 43% to 84%.[9]​[61][62]

Colorectal malignancy

Colorectal malignancy with obstruction carries an appreciable morbidity and mortality and is likely to have an adverse effect on long-term prognosis. A reduced 5-year survival has been reported in this group of patients.[63]

Rare causes

For rare causes (e.g., benign stricture), the underlying disease process dictates the long-term outcome.

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