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Malignant Bowel Obstruction — SCE Medical Oncology MCQ

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ModerateSupportive & Palliative OncologyMalignant Bowel ObstructionSCE Medical Oncology

A 55-year-old woman with advanced ovarian cancer develops small bowel obstruction. CT shows a transition point with single-level adhesive-type obstruction. She has good performance status (ECOG 1), limited peritoneal disease, and has not received chemotherapy for 6 months. What management should be considered?

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Correct answer: C — Surgical evaluation for potential resection or bypass

Unlike multifocal malignant bowel obstruction (where medical management is preferred), a single transition point with mechanical obstruction in a patient with good performance status and limited disease warrants surgical evaluation. The Cochrane review and ESMO guidelines support surgical intervention in selected patients with good PS, single-level obstruction, slow-growing tumours, and available treatment options. The decision requires MDT discussion involving surgeons, oncologists and palliative care.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/cancer