Closed loop small bowel obstruction
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Closed loopThis a case of a closed-loop small bowel obstruction. The reduced bowel wall enhancement at this segment of small bowel segments and ascites are suspicious of bowel ischaemia.
Chronic rectal faecal impaction. Due to and gross distension of colon by impacted faeces, the diagnosis of stercoral colitis should be considered (Although(although it is commonly encountered within elderly patientpatients, it can present in young patientpatients who have neurologic or muscular disorders).
PatientThis patient has previousa history of extended left hemicolectomy during infancy with primary anastomosis. The intestinal obstruction is likely due to adhesion.
Intra-operatively, a closed loop-loop obstruction secondary to adhesion bands with a short segment of small bowel ischaemia resection. Ileostomyresected and an ileostomy created.
-<p>Closed loop small bowel obstruction. The reduced bowel wall enhancement at this segment of small bowel segments and ascites are suspicious of bowel ischaemia.</p><p>Chronic faecal impaction. Due to gross distension of colon by impacted faeces, the diagnosis of <a href="/articles/stercoral-colitis">stercoral colitis</a> should be considered (Although it is commonly encountered with elderly patient, it can present in young patient who have neurologic or muscular disorders).</p><p>Patient has previous history of extended left hemicolectomy during infancy with primary anastomosis. The intestinal obstruction is likely due to adhesion.</p><p>Intra-operatively, closed loop obstruction secondary to adhesion bands with short segment of small bowel ischaemia resection. Ileostomy created.</p>- +<p>This a case of a <a title="Closed loop obstruction" href="/articles/closed-loop-obstruction">closed-loop small bowel obstruction</a>. The reduced bowel wall enhancement at this segment of small bowel segments and ascites are suspicious of <a title="Small bowel ischaemia" href="/articles/small-bowel-ischaemia">bowel ischaemia</a>.</p><p>Chronic rectal <a title="Faecal impaction" href="/articles/faecal-impaction">faecal impaction</a> and gross distension, the diagnosis of <a href="/articles/stercoral-colitis">stercoral colitis</a> should be considered (although it is commonly encountered in elderly patients, it can present in young patients who have neurologic or muscular disorders).</p><p>This patient has a history of extended left hemicolectomy during infancy with primary anastomosis. The intestinal obstruction is likely due to adhesion. Intra-operatively a closed-loop obstruction secondary to adhesion bands with a short segment of small bowel ischaemia resected and an ileostomy created.</p>
Systems changed:
- Paediatrics
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Most left sided-sided colon is absent due to previous surgical resection. The right sided-sided colon and rectum are grossly dilated and filled with a large amount of impacted faeces. The largest diameter of the colon measures up to 10.3 cm.
Abnormal U and C shape-shape small bowel loops dilatation at the left lumbar region, with a diameter up to 4.0cm. These segments of dilated ileum have reduced bowel wall enhancement compared to the normal calibercalibre and well enhanced-enhanced jejunum.No intramural gas, pneumoperitoneum or portal venous gas. Moderate ascites.
Mesenteric infiltration/fluid with mesentery lymphadenopathy noted.