Interventional treatment options for malignant intestinal obstruction

Background Malignant (gastro)intestinal obstructions (MIO) are one of the most frequent clinical findings in visceral medicine with an interdisciplinary challenge of appropriate care. They represent a particular challenge with respect to the adequate, findings-specific and timely management. Aim Presentation of the possibilities of modern interventional techniques in the treatment of symptomatic intestinal stenoses depending on the location in the oral-aboral extension of the intraintestinal/extraintestinal cause of the manifestation in the gastrointestinal tract. Method This short review is based on selected references from the current scientific literature and own clinical experience. Results The obstruction can originate from extraluminal and also intraluminal sites. Endoscopic procedures are increasing in importance. A successful intervention mostly enables a prompt and long-term symptom control and maintenance of the quality of life. Besides a successful relief of symptoms a prolongation of the lifetime should be strived for and when necessary to achieve a favorable situation for a surgical restoration. Peri-interventional morbidity and mortality are decisive target parameters of an accompanying quality assurance. Last but not least, the patient's wish is given priority. Conclusion In cases of localization-dependent MIO a differentiation must be made between curative and palliative treatment intentions, whereby multimodal treatment options need to be appropriately selected and used based on the findings and risks (with palliative intention preferably a single procedure, with curative intention preferably a combination of procedures or sequentially). This necessitates extensive clinical experience and expertise in the therapeutic management in the interdisciplinary setting and mostly in a competence center for visceral medicine.