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Palliative Management of Malignant Bowel Obstruction
  1. Carla Ripamonti1 and
  2. Eduardo Bruera2
  1. 1 Department of Palliative Care and Rehabilitation, National Cancer Institute, Milan, Italy
  2. 2 Department of Palliative Care and Rehabilitation, University of Texas, M. D. Anderson Cancer Center, Houston, Texas
  1. Address correspondence and reprint requests to: Edward Bruera, Dept. of Palliative Care and Rehabilitation Medicine (Box 8), UT M.D. Anderson Cancer Center, 1515 Holcomb Blvd., Houston, TX 77030. E-mail: ebruera{at}


Bowel obstruction may be a mode of presentation of intra-abdominal and pelvic malignancy or a feature of recurrent disease following anticancer therapy. Malignant bowel obstruction is well-recognized in gynecologic patients with advanced cancer. Retrospective and autopsy studies found the frequency at approximately 5–51% of patients with gynecological malignancy(1–7). Malignant bowel obstruction (MBO) is particularly frequent in patients with ovarian cancer where it is the most frequent cause of death(7). Patients with stage III and IV ovarian cancer and those with high-grade lesions are at higher risk for MBO as compared to patients with lower stage or low-grade tumors(1,8). Ovarian carcinoma accounted for 50% of small bowel obstruction and 37% of large bowel obstruction treated in a large gynecological oncology service(8–11).

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