Aetiology

Predominantly associated with pelvic cancers and most commonly found in ovarian (6-42%), cervical (5%), and colonic cancers (10-30%). Cause is either intra-luminal disease (more common in colonic cancer) or extra-mural compression. In ovarian and cervical cancers there are often multiple levels of obstruction. Obstruction in a patient with previous cancer may also be due to non-malignant causes (such as adhesions or gross constipation).

Obstruction may be complete, subacute, or functional; it may be intermittent. Functional obstruction may be caused by a cancer-related or drug-related (vincristine) autonomic neuropathy, by direct involvement of the mesenteric plexus, or through ileus (e.g. due to perforation).

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