Acute mechanical large bowel obstruction should be operated early because of the risk of -
Respiratory embarrassment due to abdominal distension
Electrolyte imbalance from vomiting
Septicaemia from bowel contents
Closed-loop obstruction and caecal perforation
• Virtually all patients with complete acute large bowel obstruction require prompt surgical intervention and should not undergo a trial of non-operative management
• Acute large bowel obstruction in patients with competent ileocecal valve is a true surgical emergency because of high chances of perforation (MC site: Cecum) 
• Once diagnosis has been made, surgical exploration should be undertaken as soon as possible after appropriate resuscitation