OpenOnco
UA EN
Plan Builder Onco Wiki Tumor Board

Onco Wiki / Red flag

Surgical emergency in CRC: complete bowel obstruction (closed-loop or large-bowel obstruc...

Deterministic view of the source YAML entity. Clinical authority remains with the cited source IDs and reviewer sign-off state.

IDRF-CRC-EMERGENCY-OBSTRUCTION-PERFORATION
TypeRed flag
Statusreviewed 2026-04-26 | pending_clinical_signoff
DiseasesDIS-CRC
SourcesSRC-ESMO-COLON-2024 SRC-NCCN-COLON-2025

Red Flag Origin

DefinitionSurgical emergency in CRC: complete bowel obstruction (closed-loop or large-bowel obstruction with competent ileocecal valve), perforation with peritonitis, or massive lower-GI bleed requiring transfusion. Mandates urgent surgery / interventional decompression BEFORE any systemic therapy decision; staging and biomarker work-up are deferred until patient is stabilized.
Clinical directionhold
Categoryorgan-dysfunction

Trigger Logic

{
  "any_of": [
    {
      "finding": "complete_bowel_obstruction",
      "value": true
    },
    {
      "finding": "perforation_with_peritonitis",
      "value": true
    },
    {
      "finding": "massive_lower_gi_bleed",
      "value": true
    }
  ],
  "type": "composite_score"
}

Notes

~10-30% of CRC presents with obstruction; ~3-8% with perforation. Self-expandable metal stent (SEMS) is bridge-to-surgery option for left-sided malignant obstruction in elective surgical candidates; emergency surgery for right-sided / proximal lesions and any perforation. Bevacizumab is contraindicated for ≥28 days after major abdominal surgery — relevant for subsequent metastatic-pathway planning.

Used By

Indications

Red flag