Large-bowel obstruction audit
International time-bound prospective clinical audit

One obstruction.
Many pathways.
A clearer evidence base.

IMPEL is a multicentre, non-randomized observational audit describing how adults with mechanical large-bowel obstruction are assessed, managed, and followed in routine emergency care.

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Adults ≥18 years · 90-day consecutive local window · six-month follow-up
90days

Consecutive local
inclusion window

InternationalCollaborative audit across participating emergency and colorectal services.
ProspectiveRoutine clinical data captured contemporaneously during a defined window.
StandardizedShared definitions, admission-relative timing, and quality checks.
Outcome-focusedComplications, mortality, stoma status, and recovery at six months.

A shared view of emergency obstruction care

Each centre reconstructs the pathway from routine records so that variation in diagnosis, timing, operative strategy, and recovery can be described clearly.

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Capture the pathway

Describe the care delivered

Record presentation, imaging, decompression, operative decisions, postoperative care, and discharge outcomes from routine documentation.

Compare decision points

Make variation visible

Align diagnostic and treatment timing to admission so services can understand where pathways differ.

Follow meaningful outcomes

Track recovery and stoma status

Summarize complications, mortality, readmission, stoma creation or reversal, and patient-reported gastrointestinal recovery.

Current study description: IMPEL clinical audit. The current protocol is version 1.0 dated 1 May 2026. Each centre determines its own audit, ethics, privacy, and data-governance requirements before case inclusion. View the current materials.
The local workflow

From eligible case to shared learning

  1. 1

    Identify

    Screen consecutive adult admissions with mechanical large-bowel obstruction during the local window.

  2. 2

    Characterize

    Document symptoms, physiology, imaging, aetiology, obstruction level, and bowel compromise.

  3. 3

    Follow

    Complete in-hospital data and six-month outcomes, including stoma status and late complications.

  4. 4

    Learn

    Use aggregate findings to understand practice variation and design future studies responsibly.

Bring your centre into the collaboration

Join an international network describing the pathways, resources, and outcomes that shape emergency care for large-bowel obstruction.

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For centres

Ready to participate?

Start with centre interest, local classification, consecutive case ascertainment, and a plan for six-month follow-up.

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For collaborators

Emergency surgery, colorectal, and methods collaboration

Review the study description and contact the team about analytic, clinical, or implementation collaboration.

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