[Treatment of obstructive ileus useful in patients with a malignity in their medical history]

To determine whether treatment of patients with obstructive ileus and a malignancy in the anamnesis is still useful or leads to increased morbidity and reduced quality of the remaining life.

Retrospective.

University Hospital Utrecht.

Data were collected concerning 89 patients who in the period August 1987 to July 1992 were admitted with the clinical picture of obstructive ileus and who all had a history of a malignancy treated longer than 30 days previously.

The patients were 53 females and 36 males. Over one-half of the tumours were of colorectal or gynaecological origin. In all, 56 patients were operated (17 without delay, 39 after failure of conservative treatment), the others were given only conservative treatment. The cause of the obstructive ileus in the operated patients was malignant in 38, benign in 17 and unknown in one case. Of the patients, 22 died in hospital, mostly as the consequence of progression of the original malignancy, and 2 at their own request at home. Major complications occurred in 21 of the 56 operated patients. Nevertheless 65 of the 89 patients could be discharged free of ileus.

Treatment of obstructive ileus in patients with a malignancy in the anamnesis is useful. In most cases, operation is indicated, but initial conservative treatment is justified.