Small bowel obstructions: the case for investigation for occult large bowel carcinoma

Over the last century, the incidence of adhesive small bowel obstructions has increased as the rate of operative management of abdominal conditions has risen. Concurrently, the rate of colonic cancer has also increased. One of the ways in which colonic cancer may present is as an isolated small bowel obstruction. Three cases of resolving small bowel obstruction secondary to occult carcinoma are presented and a survey of the literature is made. The conclusion is that all patients who present with a small bowel obstruction, which resolves, and who are in the cancer age group should be investigated for colonic cancer, especially when the putative causative operation was carried out some years previously; otherwise, large bowel tumours presenting as an isolated small bowel obstruction may pass undiagnosed.