Colonic obstruction as the first manifestation of ovarian carcinoma

Fourteen patients with colonic obstruction as the initial manifestation of a malignant ovarian tumor are described. Although common in advanced ovarian tumor, bowel obstruction as the presenting feature of carcinoma of the ovary is not well recognized. Clinical features were that of partial or complete large bowel obstruction, roentgenographically and pathologically involving the sigmoid colon in 12 of 14 patients. Barium enema was abnormal in all 12 patients in whom it was performed. Prognosis may be more favorable in large bowel obstruction as the first clinical manifestation of ovarian cancer than in obstruction occurring in previously diagnosed disease. Our experience suggests that consideration of ovarian pathology is indicated in the presence of signs of large bowel obstruction in women.