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This video covers the basics of large bowel obstructions. These are often surgical emergencies, but too frequently junior trainees place them in the same mental category of the much more common small bowel obstructions. We discuss how the underlying causes and much higher likelihood of closed loop physiology leads to the two key differences between LBOs and SBOs: reversibility and severity. LBOs are highly likely to be closed loop if the patient has a competent ileocecal valve, and the underlying causes of LBOs (cancer, volvulus, stricture, etc) will not resolve spontaneously without procedural intervention. We cover the three main procedural options for large bowel obstructions (resection, diversion, and stenting) and how individual vs combinations of procedures can be used to manage different disease processes. These videos are for educational purposes only. Do not use to diagnose or treat any diseases. This is not clinical advice.