What are the key clinical features that suggest a diagnosis of large bowel obstruction in a primary care setting?

Key clinical features suggesting a diagnosis of large bowel obstruction in primary care include:

• Colicky abdominal pain associated with absolute constipation, meaning no passage of flatus or stool.
• Abdominal distension, which may be persistent or frequent.
• Vomiting, which can accompany the obstruction.
• Physical examination may reveal abdominal distension and possibly an abdominal mass.
• Signs of bowel obstruction such as abdominal rigidity and guarding may indicate complications like perforation or peritonitis, requiring urgent referral.

These features warrant urgent assessment and referral for hospital evaluation and management.

In particular, the presence of colicky abdominal pain with absolute constipation, vomiting, and abdominal distension are hallmark symptoms of large bowel obstruction in the primary care setting.

Additionally, if there are signs of systemic compromise or sepsis, such as altered mental state or abnormal vital signs, urgent hospital assessment is critical.

Recognition of these features in primary care is essential to prompt timely referral and management.

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