Conservative Treatment is the First Choice for Mechanical Bowel Obstruction Caused by Colonic Inertia

Objective: To analyze and determine the clinical characteristics and diagnosis of mechanical bowel obstruction caused by colonic inertia and finds the best way to manage. Method: We reviewed the medical record of all 23 patients who diagnosed with mechanical bowel obstruction caused by colonic inertia in National Center for Colorectal Surgery, the Third Affiliated Hospital of Nanjing University of Chinese Medicine from 2005 to 2013 and analyze the clinical character characteristics and follow up them after treatment. Results: 21 patients were relieved by conservative treatment. Abdominal distension occurs repeatedly in one patient, ileostomy was performed for him. The patient who had history of transverse colostomy and the stoma closing surgery was not relived by conservative treatment and the obstruction progressed. Emergency Subtotal colectomy and ilealrectal anastomosis was performed for her. Follow-up 1-8 years (mean follow-up time: 4.7yrs ) was done for the 23 patients. Two patients who were performed surgical operation without any discomfort. The symptoms of bowel obstruction were recurrence in 8 patients, symptoms of 6 patients were relieved by conservative treatment again, and subtotal colectomy and ilealrectal anastomosis was performed for 2 patients. The remaining 13 patients without recurrence. Conclusion: The conservative treatment is the first choice for mechanical bowel obstruction caused by colonic inertia. Ileostomy is a good choice for the patients whose obstruction symptoms sustained. At the emergency condition, the total colectomy should not be performed for it is in high risk.