Intestinal Obstruction Research Articles

Important practical aspects in the management of patients with shot bowel syndrome and intestinal failure

Short bowel syndrome is a gastrointestinal disorder resulting from massive resection of the small intestine. The most common causes of resection are acute mesenteric ischemia, Crohn’s disease, abdominal trauma, adhesive intestinal obstruction, intestinal malignancies, and radiation enteritis. Short bowel syndrome with intestinal failure is characterized by severe malabsorption-m aldigestion accompanied by abdominal pain, diarrhea, dehydration, and progression of protein-energy malnutrition. Many patients with SBS develop long-term clinical complications over time due to altered bowel anatomy and physiology or various therapeutic interventions such as parenteral nutrition and central venous catheterization. This review focuses on the most important aspects of diagnosis, treatment, and prevention of several complications that can occur in this patient population, including macronutrient and micronutrient imbalances, diarrhea, fluid and electrolyte imbalances, metabolic bone disease, biliary disorders, bacterial overgrowth in the small intestine, and complications related to venous access. The main therapeutic strategies for SBS with intestinal failure are: special diet, enteral nutritional support with semi-elemental mixtures, parenteral nutrition, oral rehydration, antimicrobal and antidiarrheal drugs, enzymes. Administration of glucagon-like peptide 2 analog, teduglutide, is clinically effective in reducing dependence on parenteral nutrition and improving quality of life. Management of patients with SBS with intestinal failure is a complex long-term process which requires dynamic clinical and laboratory monitoring.

A Multimodal Approach to the Management of Diverticular Abscess with Paraesophageal Hernia Complication

This study aims to evaluate the management of acute diverticulitis complicated by hernia and the role of electroacupuncture in managing postoperative ileus. The case involved a 51-year-old male patient who presented with left lower abdominal pain, fever, and defecation disorder. Physical examination showed signs of infection with localized peritonitis, while laboratory tests revealed neutrophilia. CT scan showed diverticulitis with abscesses in the descending and sigmoid colon, as well as free air around the colon and perihepatic region, and paraesophageal hernia. The patient underwent left hemicolectomy with Hartmann's procedure. Postoperatively, the patient developed ileus which was treated using electroacupuncture. The results showed that the relationship between diverticulosis and hernia is due to connective tissue changes. Approximately 10-20% of diverticulosis cases progress to acute diverticulitis. CT scan is the gold standard for diagnosis, staging and management of diverticulitis. In cases of Hinchey III diverticulitis, laparoscopic washing does not give better results compared to colonic resection. The Hartmann procedure is recommended for patients with multiple comorbidities. Electroacupuncture proved to be an effective adjunctive therapy in managing postoperative ileus. The conclusion of this study is that a multimodal approach, including surgery and complementary therapies such as electroacupuncture, is essential in the management of diverticulitis and its complications. The implication of this study is the need for a holistic approach in managing patients with acute diverticulitis, especially in cases with multiple comorbidities and risk of postoperative complications.

Generalized tuberculosis with intestinal lesion in an adolescent. Case report

In the two recent decades a decrease in tuberculosis (TB) incidence has been observed worldwide, according to the World Health Organization, while the incidence of extrapulmonary TB, including TB of the intestine, is growing. Generally, diagnosis of TB in children and adolescents is difficult due to its subclinical course in a significant part of patients. A special diagnostic challenge is extrapulmonary TB, including abdominal TB. Abdominal TB has entered the top five most frequent manifestations of extrapulmonary TB along with TB of the peripheral lymph nodes, urogenital TB, bone and joint TB, and TB of the central nervous system. Lack of specific clinical signs of the disease results in late diagnosis of abdominal TB. We described a case of generalized TB with intestinal lesion in an adolescent. We detected mistakes in the follow-up of the female patient with double exposure to household TB, which resulted in late diagnosis of the disease. We demonstrated the challenges in diagnosing intestinal TB under the guise of appendicitis, which led to the development of complications – spilled peritonitis and abdominal abscess. The tactics of management of the female patient at high risk for developing bowel obstruction was represented. Interdisciplinary interactions with extrapulmonary TB specialists were accented for cases of generalized TB.

Anti-LAN Antibodies: Clinical Implications and Case Presentation

Abstract Introduction/Objective The LAN system, originating from the 901 Series of High Incidence antigens, transitioned to a recognized System in 2012. The LAN antigen, situated on ABCB6, a multipass membrane protein associated with porphyrin transport, plays a crucial role in heme synthesis. Functionally, LAN acts as an ATP-binding cassette transporter on the red blood cell membrane. Comprising a single antigen, LAN exhibits elevated expression in various tissues including the heart, skeletal muscles, fetal liver, mitochondrial membrane, eye, and Golgi apparatus. Notably, LAN shows no specific association with any particular geographic or ethnic group. Resistant to Ficin/Papain, Trypsin, α-Chymotrypsin, and 0.2M DTT, LAN antibodies primarily consist of IgG and necessitate IAT for detection. While Anti-LAN has been implicated in Hemolytic Transfusion Reactions (HTRs), its involvement in Hemolytic Disease of the Fetus and Newborn (HDFN) remains infrequent. LAN-negative blood is exceedingly rare, often requiring Monocyte Monolayer Assay Testing (MMA) for clinical assessment. Methods/Case Report Case Presentation: An 81-year-old female with a medical history including seizure disorder, hypertension (HTN), hyperlipidemia (HLD), gastroesophageal reflux disease (GERD), small bowel obstruction, and high-grade de-differentiated metastatic retroperitoneal liposarcoma presented for preoperative evaluation. A type and screen ordered as part of outpatient preoperative assessments revealed a positive antibody screen. Further investigation traced the origin of the anti-LAN antibody to an external facility since 2017. Antibody identification indicated the reactivity of the patient’s plasma with all cells (1+ AHG in PEG), excluding the auto control. Utilizing rare frozen antisera anti-LAN, the patient was phenotyped for LAN, yielding a LAN-negative status. Subsequent testing with three rare frozen LAN-negative group O cells aimed to exclude clinically significant antibodies. Differential adsorption, employing a comprehensive baseline RBC phenotype record obtained from the external facility, ruled out anti-E, anti-K, and anti-Fyb, thereby confirming Anti-LAN specificity. Results (if a Case Study enter NA) NA Conclusion The exceptional rarity of LAN-negative blood underscores the high prevalence of reactivity to Anti-LAN antibodies, exceeding 99% in most populations. In select cases, autologous transfusion may emerge as a viable management strategy. Consequently, the patient’s surgical procedure has been deferred, with no immediate requirement for blood products.

Comparison of Abdominal and Vaginal Hysterectomy: A Comparative Clinical Study at A Tertiary Hospital of Southern Part of Bangladesh

Background: Hysterectomy is indicated in several common gynecologic problems and is one of the commonly performed operations in many hospitals of Bangladesh. Though Hysterectomy is a reasonably safe operative procedure but at times minor to major complications may occur. Current study was undertaken to compare the feasibility and safety of abdominal hysterectomy (AH) and vaginal hysterectomy (VH) procedures in the treatment of benign uterine diseases, and to determine the outcomes of both procedures. Objectives: To compare outcomes of vaginal and abdominal hysterectomy procedures in women with benign gynaecological diseases. Materials and Methods: This was a prospective study of outcomes of consecutive patients who underwent AH or VH for benign gynaecological diseases. Patient characteristics before, during, and after the operations were reviewed. Patients were followed up for three months to evaluate postoperative complications. Results: This study included a total of 305 patients. 199 patients underwent AH and 106 patients underwent VH. Baseline characteristics were similar between the two groups. Mean operative time was 95.78±18.46 minutes for AH group and 76.26±19.24 minutes for VH group (p<0.006). Mean hospital stay was 5.32±0.67 days for AH group and 4.08±0.19 days for VH group with p-value <0.047. There was a significant lesser total operation cost in VH group than AH group (VH: 12058±386 BDT, AH: 14275±276 BDT; P < 0.05). Furthermore there was no wound infection; paralytic ileus and no need to reopening any patient in case of VH group compared to AH group. Conclusion: This study showed that vaginal hysterectomy was associated with less intraoperative complications and postoperative morbidities and complications as compared to abdominal hysterectomy. KYAMC Journal Volume: 15, No: 01, April 2024: 40-45.

Current research status of Peutz-Jeghers syndrome in children

Peutz-Jeghers syndrome (PJS) is an autosomal dominant genetic disorder characterized by mucocutaneous pigmentation and multiple hamartomatous polyps, which leads to an increased susceptibility to tumors. The clinical incidence is rare, and the only currently identified pathogenic gene is the serine/threonine kinase 11/liver kinase B1 (STK11/LKB1) located on the short arm of chromosome 19 (19p13.3). This condition can lead to various complications, such as gastrointestinal bleeding, intussusception, intestinal obstruction, and malignancy. In childhood, the greatest risk is associated with intussusception, which increases the risk of surgical intervention and significantly impacts the growth, development, and quality of life of the children. This article provides an overview of the current research status regarding the clinical characteristics, etiology, pathogenesis, diagnosis, and treatment of PJS in children.

ОСТРАЯ СПАЕЧНАЯ КИШЕЧНАЯ НЕПРОХОДИМОСТЬ У БЕРЕМЕННОЙ (КЛИНИЧЕСКИЙ СЛУЧАЙ)

Acute intestinal obstruction during pregnancy is a rare but extremely dangerous surgical pathology. Despite advances in medical technologies, preoperative diagnosis of acute surgical conditions of the abdominal organs during pregnancy is still imperfect. During pregnancy the clinical picture of the disease and laboratory parameters are nonspecific and variable which causes untimely provision of care and severe complications for both the mother and the fetus. The high incidence of acute intestinal obstruction during pregnancy is due to the adhesive process caused by surgical interventions including caesarean section the rates of which continue to rise steadily. The article presents a clinical case of a patient whose pregnancy was complicated by acute adhesive intestinal obstruction caused by the adhesive process after a previous caesarean section. The authors have noted the importance and necessity of multifield cooperation, timely decision-making both at the stage of diagnostic examination and during treatment, which made it possible to avoid severe complications from both the mother and the fetus.

Phytobezoar as a Cause of Recurrent Obturation Intestinal Obstruction. A Clinical Case in Surgical Practice

Introduction. Phytobezoar refers to a foreign body accumulated in the stomach when swallowing substances of natural or synthetic origin. Phytobezoar is formed in the stomach and small intestine, its etiopathogenesis is yet to be investigated. It causes obturation intestinal obstruction, which requires emergency surgical intervention. The paper presents a clinical case in surgical practice of phytobezoar in the small intestine which was complicated by a recurrent obturation intestinal obstruction. Aim: to present a clinical case of phytobezoar in the form of recurrent obturation intestinal obstruction. Materials and methods. 66­years old female patient Kh. underwent surgical treatment for obturation intestinal obstruction caused by phytobezoar twice within a short period of time. The gastric resection and consumption of bezoar-dangerous products due to a dried­fruit diet were considered to be the prerequisite for the formation of phytobezoar. According to the pathomorphologic examination, the intervention included laparotomy, enterotomy and phytobezoar extraction. Results and discussion. A complete revision of the abdominal cavity organs was performed during the first laparotomy with no other fragments of phytobezoar found. Following the first surgery and before discharge, the patient underwent ultrasound, CT scan of abdominal cavity organs, fibrogastroscopy — no volumetric pathologic formations in the abdominal cavity were detected. Therefore, the phybobezoar was assumably formed again in a relatively short period of time and led to the development of reobstruction. The patient was discharged with recovery.Conclusion. The clinical case shows that in surgical practice phytobezoar can get formed repeatedly in a short period of time and lead to the development of recurrent intestinal obstruction.

Malignant Small Bowel Obstruction from Hernia Mesh Invasion by Jejunal Adenocarcinoma: A Report of a Rare Case

Malignant Small Bowel Obstruction from Hernia Mesh Invasion by Jejunal Adenocarcinoma: A Report of a Rare Case

Oral Gastrografin: A Safe Alternative in Meconium Obstruction of Prematurity

Meconium obstruction of prematurity is primarily seen among very low birthweight or extremely low birthweight premature babies, causing low intestinal obstruction. It may delay the establishment of early full enteral feeding and compromise nutrition or cause obstruction requiring surgery or intestinal perforation. Currently, the management is mainly based on expert opinion and low-quality evidence. Conventional hyperosmolar contrast enema and gastrografin enema may not reach the site of obstruction because of the proximal nature of the meconium obstruction. Oral gastrografin is an effective and safe alternative for relieving meconium obstruction in a 28-week preterm baby. This avoids the need for surgery. This article highlights the use of oral route of gastrografin as a good nonsurgical alternative in extreme preterm babies in resource-limited circumstances.

Long-Term Efficacy and Safety of Adhesion Prevention Agents in Abdominal and Pelvic Surgeries: A Systematic Review.

This systematic review evaluates the long-term efficacy and safety of adhesion prevention agents in abdominal and pelvic surgeries, synthesizing data from randomized controlled trials and meta-analyses. Adhesions, common postoperative complications, can lead to significant morbidity, including chronic pain, infertility, and bowel obstruction. Various agents, including hyaluronic acid-carboxymethylcellulose films and icodextrin solutions, have been developed to mitigate these risks. Our review highlights that agents like bioresorbable membranes (Seprafilm) and icodextrin significantly reduce the incidence and severity of adhesions, particularly in high-risk surgeries. However, certain complications such as anastomotic leaks and infections are associated with some agents, emphasizing the need for careful consideration in clinical decision-making. Additionally, while these agents reduce postoperative morbidity and enhance recovery, further research is needed to assess their long-term impact, particularly regarding fertility outcomes and chronic pain. This review underscores the importance of integrating adhesion prevention agents into surgical protocols, which has the potential to reduce healthcare costs, improve patient outcomes, and optimize postoperative care pathways. Standardization of adhesion prevention practices could further enhance surgical efficiency and patient recovery, particularly in high-risk patient populations and complex surgeries.

Standardization of the Umbilical Scarectomy and Exploratory Laparotomy for Umbilical Mucosal Polyps.

Background Umbilical mucosal polyps are common, but physicians' unfamiliarity with them can prolong the patient's illness. Furthermore, the details of surgery for umbilical mucosal polyp removal are not well documented. Methods Patients with an umbilical mucosal polyp diagnosed on the basis of the lesion's characteristic appearance were prospectively enrolled. The surgery involved an umbilical scarectomy with the removal of a minimum of the surrounding skin and an exploratory laparotomy to detect any lesions extending into the peritoneal cavity. Results Fourteen patients with a median duration of illness of ten months (range: one month to seven years) were enrolled, and 13 (92.9%) received surgery while one patient whose symptoms resolved following topical steroid treatment did not. Inspection of the intestinal mucosa of all the patients found lesions deep within the umbilicus in four (30.8%) of the 13 surgical patients, including an omphalomesenteric band, umbilical cyst, and umbilical sinus with gastric mucosa in one, one, and two patients, respectively. The postoperative course was uneventful except for one patient who had temporary granulation. Conclusions Umbilical mucosal polyps can be readily diagnosed by their characteristic appearance, thereby preventing the prolongation of illness. An umbilical scarectomy and abdominal exploration may be useful for preventing recurrences and intestinal obstruction.

Internal Supravesical Hernia Revealed by Small Bowel Obstruction

The supravesical hernia is a rare cause of internal hernia, characterized by the protrusion of the intestine through an abnormal intra-abdominal opening located in the supravesical compartment. This anomaly is infrequently reported in the literature, and its incidence remains uncertain [1]. Supravesical hernias predominantly affect men over the age of 50 [2]. From a pathophysiological perspective, supravesical hernias develop from the supravesical fossae. They form medial to the umbilical arteries and often expand into the Retzius space, though they can also engage laterally, resulting in laterovesical hernias. These hernias are almost always acquired and can sometimes be associated with inguinal hernias. Clinically, they present as acute bowel obstruction. An abdominal CT scan can confirm the diagnosis of obstruction but rarely provides an etiological diagnosis [3]. In such cases, a median laparotomy is necessary, and intraoperative diagnosis is typically straightforward. Treatment involves sectioning the hernial neck and reducing the hernia, followed by simple closure of the opening using separate sutures with absorbable thread [4]. We report a case of a 56-year-old patient with no notable medical history was admitted to the emergency department with an internal supravesical hernia revealed by obstructive syndrome.

Ultrasound-Guided Transversus Abdominis Plane Block as an Effective Path to Reduce Opioid Consumption After Laparoscopic Bariatric Surgery: A Systematic Review and Meta-analysis of Randomized Controlled Trials.

Effective postoperative pain management is essential to the patient's recovery. The use of opioids as the primary line of pain treatment has been known to increase rates of length of stay, pulmonary complications, paralytic ileus, and nausea and vomiting. Therefore, guidelines strongly recommend alternative paths to reduce opioid consumption through multimodal analgesia, and the transversus abdominis plane block(USG-TAP) has been considered to be one of these optimistic alternatives. A comprehensive systematic search was conducted in four databases until April 2024. We only considered for this analysis randomized controlled trials that assessed the USG-TAP as part of multimodal anesthesia in patients undergoing laparoscopic bariatric surgery. Eleven studies comprising 789 patients were included in the meta-analysis. Our results showed a significant decrease in opioid consumption after the first 24h of surgery (MD - 32.02mg; 95% IC - 51.33, - 12.71; p < 0.01) and fewer patients required extra-dose of opioid (OR 0.20; 95% IC 0.07, 0.62; p < 0.01). The pain score showed to be also improved with the TAP block (MD - 0.69; 95% IC - 1.32, - 0.07; p = 0.03). No difference concerning time to deambulate, nausea and vomiting, and time of surgery was observed among the studies. This study reinforces the benefits of the use of USG-TAP block as part of multimodal analgesia in patients undergoing laparoscopic bariatric surgery.

Outcomes of robotic surgery for inflammatory bowel disease using the Medtronic Hugo™ Robotic-Assisted Surgical platform: a single center experience

PurposeThe aim of the study was to compare the perioperative outcomes of patients affected by inflammatory bowel disease (IBD) who underwent surgery performed through laparoscopy or using the Medtronic Hugo™ RAS.MethodsThis is a retrospective study from a prospectively maintained database comparing laparoscopic vs. robotic-assisted surgery for IBD from 01/11/2017 to 15/04/2024. All procedures were performed by a single surgeon robotic-naïve with a large experience in laparoscopic surgery for IBD. The robotic procedures were performed using the Medtronic Hugo™ RAS platform. Outcomes were 30-day postoperative complications, operative time, conversion rate, intraoperative complications, length of hospital stay, and readmission rate.ResultsAmong 121 consecutive patients, 80 underwent laparoscopic (LG) and 41 robotic-assisted surgery (RG). Baseline, preoperative and disease-specific characteristics were comparable except for older age (50 [38–56] vs. 38 [28–54] years; p = 0.05) and higher albumin level (42 [40–44] vs. 40 [38–42] g/L, p = 0.006) in the RG. The intracorporeal anastomosis was more frequent in the RG (80% vs. 6%; p < 0.001) with longer operative time (240 vs. 205 min; p = 0.006), while the conversion rate was not different (5% vs. 10%, p = 0.49). Surgical procedure types were equally distributed between the two groups, and the rate of intra-abdominal septic complication (IASC) was comparable across the different procedures. Postoperative complications were similar, including the rate of IASC (5% vs. 5%, p = 1), postoperative ileus (5% vs. 7.5%, p = 0.71), bleeding (2% vs. 5%, p = 0.66), and Clavien-Dindo > 2 complications (7% vs. 6%; p = 1).ConclusionIBD surgery performed using the Medtronic Hugo™ RAS is safe and feasible, with similar postoperative outcomes when compared to the laparoscopic approach.

Grip strength predicts postoperative ileus among patients undergoing abdominal minimally invasive surgery: a prospective multicenter cohort study.

Postoperative ileus (POI) is a prevalent complication following abdominal surgery, leading to extended hospitalization and escalated medical expenses. Few studies have investigated the association between grip strength and POI after abdominal minimally invasive surgery (MIS). A prospective multicenter cohort study was conducted using data from a prospectively registered database of patients undergoing abdominal MIS from March to December 2022. Grip strength levels were categorized and analyzed for their association with POI using multiple regression analysis with demographic adjustments. A smooth curve was generated to visualize the linear relationship. Out of 501 eligible patients, 393 were analyzed, with 67 (17.05%) developing POI. Grip strength was significantly and independently associated with POI, with each 1kg and 8.57kg (SD) increase in grip strength resulting in ORs of 0.94 and 0.61, respectively. Grip strength categories specific to sex and age were significantly associated with POI incidence, with individuals in the high grip strength group having a lower risk. Subgroup analysis showed grip strength as a significant predictor of POI risk, especially for males and older individuals. Higher grip strength was associated with a significantly lower risk of POI in males (OR = 0.29, 95% CI 0.09-0.90, p = 0.031) and older adults over 60years old (OR = 0.31, 95% CI 0.10-0.98, p = 0.046). Grip strength can predict the occurrence of POI in patients undergoing abdominal MIS. This can help identify high-risk individuals and improve perioperative management for better outcomes.

Small bowel obstruction

Small bowel obstruction is a common and serious condition that nurses often encounter, making up 80% of bowel obstructions in the US. It frequently occurs in older adults and those who've had abdominal surgeries, with many cases requiring surgical intervention, especially for complete obstructions.

An unusual case of small-bowel obstruction: Broad ligament hernia.

Broad ligament hernias (BLHs) are rare internal hernias that can lead to serious complications if left untreated. In this case report, we present the case of a BLH in a female patient and discuss its clinical presentation, diagnosis and management. A 40-year-old woman presented with subacute intestinal obstruction symptoms, including the inability to pass flatus and faeces and recurrent bilious vomiting. A computed tomography (CT) scan confirmed small-bowel obstruction adjacent to the uterus within the left broad ligament. Diagnostic laparoscopy revealed a loop of obstructed small intestine within the broad ligament, which was released and found to be healthy. The defect between the broad and infundibulopelvic ligaments was closed with sutures. The patient had an uneventful recovery and was asymptomatic at a 6-month follow-up. BLHs can be congenital or acquired, with acquired defects often resulting from previous surgeries or pregnancy-related causes. The clinical presentation typically involves the symptoms of bowel obstruction, and a CT scan is the diagnostic modality of choice, showing characteristic findings such as closed-loop obstruction and bowel dilation. Laparoscopic management offers the advantages of faster recovery and less morbidity. Closure of the defect using nonabsorbable sutures is the standard surgical approach, although a wide opening of the defect has also been described. Recurrence is a possibility, particularly if absorbable sutures are used for closure. This case report highlights the importance of early diagnosis and intervention in BLHs to prevent the complications and emphasises the role of laparoscopy in their management.

Laparoscopic Management of Acute Small Bowel Obstruction: A Retrospective Study at a Tertiary Center in the United Kingdom.

Objectives To present a single-center experience of laparoscopic management of acute small bowel obstruction (ASBO) based on seven years of data and demonstrate its suitability for the United Kingdom (UK). Methods A retrospective review of case notes to evaluate postoperative outcomes was conducted. All emergency small bowel obstructions treated laparoscopically were included. The cases that were converted to a laparotomy were excluded. Demographics (age, sex), American Society of Anesthesiologists (ASA) grade, indication for surgery, duration of stay, complications, requirement of stoma, requirement of intensive treatment unit/high dependency unit (ITU/HDU), reoperation/readmissions, and 30-day mortality were noted. The results were tabulated and analyzed accordingly. Results There were 119 patients studied, with a median age of 66 (range: 17-97). The sex ratio was 62 females to 57 males. Primary etiologies of adhesion bands (49.5%, 59) and hernia (31.9%, 38) werethe most common. Minor and majorcomplications were 15 (12.6%) and 37 (31%),respectively. Three (2.5%) patients passed away within 30 days of surgery. The medianlength of stay (LOS) was eight days. ThemedianLOS subgroup analysis showed nine days for adhesiolysis and six days for hernias. Discussion This study shows that there is significant heterogeneity in outcomes regarding small bowel obstruction around the world. We have demonstrated similar to better results in our center relative to other prominent centers in the UK. This can be attributed to the patient cohort, presentation, and physiological status on admission, delay to surgery, and associated co-morbidities to name a few. Conclusion This study indicates that laparoscopic surgery is a safe approach to treating ASBO, provided adequate expertise and infrastructure are available.

Machine Learning Approaches for the Prediction of Postoperative Major Complications in Patients Undergoing Surgery for Bowel Obstruction.

Performing emergency surgery for bowel obstruction continues to place a significant strain on the healthcare system. Conventional assessment methods for outcomes in bowel obstruction cases often concentrate on isolated factors, and the evaluation of results for individuals with bowel obstruction remains poorly studied. This study aimed to examine the risk factors associated with major postoperative complications. We retrospectively analyzed 99 patients undergoing surgery from 2015 to 2022. We divided the patients into two groups: (1) benign-related obstruction (n = 68) and (2) cancer-related obstruction (n = 31). We used logistic regression, KNN, and XGBOOST. We calculated the receiver operating characteristic curve and accuracy of the model. Colon obstructions were more frequent in the cancer group (p = 0.005). Operative time, intestinal resection, and stoma were significantly more frequent in the cancer group. Major complications were at 41% for the cancer group vs. 20% in the benign group (p = 0.03). Uni- and multivariate analysis showed that the significant risk factors for major complications were cancer-related obstruction and CRP. The best model was KNN, with an accuracy of 0.82. Colonic obstruction is associated with tumor-related blockage. Malignant cancer and an increase in C-reactive protein (CRP) are significant risk factors for patients who have undergone emergency surgery due to major complications. KNN could improve the process of counseling and the perioperative management of patients with intestinal obstruction in emergency settings.