Malignant bowel obstruction

Abstract

Malignant bowel obstruction (MBO) is a complex medical challenge in advanced malignancies. For patients, it represents a highly symptomatic and distressing condition, while for physicians, it poses interdisciplinary communication difficulties and ethical dilemmas. Key considerations in surgical decision-making include frailty assessment, response to conservative management, surgical feasibility, the necessity of parenteral nutrition (PN), evaluation of anabolic potential, and patient preferences. Given the high 30-day mortality rate associated with surgery (1,2), these factors play a crucial role in determining the appropriateness of surgical intervention. Even in cases where surgery is technically feasible, conservative management remains a cornerstone approach, supported by medical evidence and the significant relevance of end-of-life considerations.