Journal of the American College of Surgeons
Volume 195, Issue 1 , Pages 117-128 , July 2002

When the sun can set on an unoperated bowel obstruction: management of malignant bowel obstruction1

  • Robert S Krouse, MD

      Affiliations

    • Corresponding Author InformationCorrespondence address: Robert S Krouse, MD, Surgical Care Line, 2-112, Southern Arizona Veterans Affairs Health Care System, Tucson, AZ 85723USA
    • Department of Surgery, University of Arizona and the Southern Arizona Veterans Affairs Health Care System, Tucson, AZ, (Krouse); USA
  • ,
  • Laurence E McCahill, MD (FACS)

      Affiliations

    • Department of General Surgical Oncology, City of Hope National Medical Center, Duarte, CA, (McCahill); USA
  • ,
  • Alexandra M Easson, MD

      Affiliations

    • Department of Surgical Oncology, Princess Margaret Hospital, University Health Network, Toronto, (Easson); Canada
  • ,
  • Geoffrey P Dunn, MD (FACS)

      Affiliations

    • Department of Surgery, Hamot Medical Center, Erie, PA, (Dunn), USA

Received 6 March 2002 ,Accepted 6 March 2002.

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PII: S1072-7515(02)01223-1

Journal of the American College of Surgeons
Volume 195, Issue 1 , Pages 117-128 , July 2002