For patients with colorectal cancer presenting with obstruction, what is an immediate intervention to relieve the obstruction?

• A. Emergency resection
• B. Water-soluble contrast enema or stenting as bridge to definitive surgery
• C. Immediate colostomy
• D. Observation and NG decompression

Answer: (B)

When colorectal cancer causes a bowel obstruction, the priority is to relieve the blockage and convert an emergency situation into a planned, elective operation for cancer cure. Using a bridge to definitive surgery achieves this by decompressing the obstructed colon with a less invasive method, then proceeding to definitive resection under more favorable conditions. A water-soluble contrast enema can provide hydrostatic relief and help localize the obstruction, and placing a colonic stent can quickly decompress the blocked segment, turning an emergency colectomy into an elective procedure with better outcomes.

Relying on observation with NG decompression leaves the obstruction unresolved and risks deterioration, while emergency resection or immediate diversion without prior decompression carries higher morbidity in the obstructed setting. Thus, decompression with a bridge to surgery—via contrast enema or stenting—is the best immediate strategy.