Abstract:

Malignant bowel obstruction(MBO) is a common complication of advanced ventral-pelvic tumors, with poor overall prognosis and seriously affecting the quality of life of these patients. Numerous factors are involved in the pathogenesis of MBO and there is no standard treatment. Most MBO patients were not suitable for surgery. The use of chemotherapy and total parenteral nutrition(TPN) is also controversial. The best treatment is still supportive treatment, including drug treatment and gastrointestinal decompression. Here we reported a case diagnosed as MBO. Transnasal ileus cathete was inserted immediately when hospitalizated after diagnosed 5 days. The symptom was partial relieved after conservative treatment. The abdomen CT scan suggested the sign of closed-loop obstruction. Then, an exploratory laparotomy was performed and found proximal small intestine obviously decompressed with transnasal ileus catheter. However, the tumor caused the closed-loop obstruction of terminal ileum and colon, then the transverse colostomy and terminal ileostomy were performed. After treatment, the patient recovered and was discharged from the hospital. In conclusion, the use of transnasal ileus catheter combined with surgery in MBO, could improve the accuracy of condition judgment, increase the feasibility and safety of surgery, and achieved the goals of treatment expected, and might be a potential treatment regimen for MBO.

Key words: Malignant bowel obstruction, Transnasal ileus catheter, Surgery, Conservative treatment