What are the common complications of bowel obstruction that I should be aware of in my practice?

Common complications of bowel obstruction to be aware of in clinical practice include:

• Bowel ischemia and necrosis: Prolonged obstruction can compromise blood flow, leading to ischemia, necrosis, and potential perforation, which significantly increase morbidity and mortality risks ¹.
• Perforation and peritonitis: Obstruction may cause bowel wall perforation, resulting in generalized peritonitis, sepsis, and the need for urgent surgical intervention ¹,².
• Sepsis and systemic infection: Secondary to perforation or bacterial translocation, sepsis is a serious complication requiring prompt recognition and management ¹,².
• Abscess formation: Localized intra-abdominal abscesses can develop, especially in complicated diverticulitis or post-obstructive inflammation, sometimes necessitating drainage or surgery ².
• Stricture and fistula formation: Chronic obstruction, particularly in inflammatory bowel diseases like Crohn’s, can lead to strictures and fistulae, complicating management ⁷.
• Postoperative complications: After surgical treatment of obstruction, complications such as wound infection, small bowel obstruction, and anastomotic leakage may occur ¹.
• Malnutrition and electrolyte imbalances: Obstruction often leads to vomiting and poor intake, causing dehydration, electrolyte disturbances, and nutritional deficiencies that require correction ¹[(Costa et al., 2016)].
• Recurrence of obstruction: Particularly in malignant or inflammatory causes, there is a risk of recurrent obstruction necessitating ongoing management ³[(Zanatto et al., 2022)].

Awareness of these complications supports timely diagnosis, appropriate referral, and management decisions in general practice, including urgent hospital admission when signs of systemic infection, perforation, or ischemia are present ¹,²[(Costa et al., 2016)].