PAEA Surgery End Of Rotation (EOR) Practice Exam

What is the number one cause of colonic obstruction?

1. Diverticular disease

2. Neoplasm

3. Volvulus

4. Adhesions

The correct answer is: Neoplasm

The leading cause of colonic obstruction is neoplasm, which refers to abnormal tissue growth, often resulting from cancerous tumors. Neoplasms can obstruct the lumen of the colon both by physically occupying space within the bowel and by causing strictures that lead to blockage. In cases of colorectal cancer, especially when tumors are large or located at critical junctions in the bowel, they commonly lead to obstruction. Understanding this is crucial, as neoplastic obstructions can present with significant symptoms, including abdominal pain, bloating, changes in bowel habits, and sometimes even acute abdomen if the bowel becomes ischemic or perforates due to the obstruction. Early identification and management of neoplasms are vital, given the potential for progression to more advanced disease and the associated increase in morbidity. While other causes such as diverticular disease, volvulus, and adhesions can also lead to colonic obstruction, neoplasms are statistically more prevalent in presenting as the primary cause, particularly in adult populations where cancer incidence is higher.