Examination of Physicians’ Perception of the Indications of Colorectal Stents in the Management of Malignant Large Bowel Obstruction: A Provincial Survey

Box 1

Clinical scenarios of different cases of malignant large bowel obstruction.

“How would you manage this patient?”

Scenario 1 (young, no comorbidities). A 60 year-old male, previously healthy, presents in acute large bowel obstruction.

CT-scan of the abdomen suggests an obstructing sigmoid tumor without evidence of local spread or distant metastases.

Scenario 2 (elderly, no comorbidities). A 90 year-old male, previously healthy, presents in acute large bowel obstruction.

CT-scan of the abdomen suggests an obstructing sigmoid tumor without evidence of local spread or distant metastases.

Scenario 3 (young, comorbidities). A 60 year-old male, known for poorly-controlled diabetes and moderate chronic obstructive

pulmonary disease, presents in acute large bowel obstruction. CT-scan of the abdomen suggests an obstructing sigmoid

tumor without evidence of local spread or distant metastases.

Scenario 4 (elderly, comorbidities). A 90 year-old male, known for poorly-controlled diabetes and moderate chronic obstructive

pulmonary disease, presents in acute large bowel obstruction. CT-scan of the abdomen suggests an obstructing

sigmoid tumor without evidence of local spread or distant metastases.

Scenario 5 (young, no scheduled chemotherapy). A 60 year-old male, known for metastatic colorectal cancer

(no chemotherapy scheduled), presents in acute large bowel obstruction. CT-scan of the abdomen suggests an obstructive

sigmoid tumor with evidence of local spread and/or distant metastases. Family and patient prefer a palliative approach.

Scenario 6 (elderly, no scheduled chemotherapy). A 90 year-old male, known for metastatic colorectal cancer

(no chemotherapy scheduled), presents in acute large bowel obstruction. CT-scan of the abdomen suggests an

obstructive sigmoid tumor with evidence of local spread and/or distant metastases. Family and patient prefer

a palliative approach.

Scenario 7 (young, ongoing chemotherapy). A 60 year-old male, known for metastatic colorectal cancer

(undergoing chemotherapy with bevacizumab), presents in acute large bowel obstruction. CT-scan of

the abdomen suggests an obstructive sigmoid tumor with evidence of local spread

and/or distant metastases. Family and patient prefer a palliative approach.

Scenario 8 (elderly, ongoing chemotherapy). A 90 year-old male, known for metastatic colorectal cancer

(undergoing chemotherapy with bevacizumab), presents in acute large bowel obstruction. CT-scan

of the abdomen suggests an obstructive sigmoid tumor with evidence of local

spread and/or distant metastases. Family and patient prefer a palliative approach.