Mechanical large-bowel obstruction is a common and high-risk emergency surgical condition with substantial variation in diagnostic evaluation, operative timing, and management strategies across institutions and healthcare systems. Evidence guiding optimal management remains limited and is largely derived from retrospective or single-center studies.
IMPEL is an international, multicenter, time-bound, prospective observational cohort study designed to characterize real-world presentation, diagnostic pathways, operative and non-operative management, and short-term outcomes in adults presenting with mechanical large-bowel obstruction. By capturing standardized patient-level, radiologic, operative, and outcome data across diverse acute care settings, IMPEL aims to describe contemporary practice patterns, quantify variation in care, and identify factors associated with morbidity, mortality, and stoma-related outcomes.
Age 18 years or older
Hospital admission with mechanical large-bowel obstruction, with or without associated perforation
Managed operatively or non-operatively according to local standard practice
Functional or pseudo-obstruction without a mechanical lesion
Pediatric patients (<18 years)
Patients not admitted to hospital
Isolated large-bowel perforation unrelated to obstruction
European Society for Trauma and Emergency Surgery
Lead sponsor
Association of Surgeons of Great Britain and Ireland
Collaborator
European Society of Coloproctology
Collaborator
American Society of Colon and Rectal Surgeons
Collaborator
University of Pennsylvania
Collaborator