Adhesional small bowel obstruction

Case contributed by Dr Ian Bickle

Presentation

Distended abdomen. Appendicectomy 18 months prior.

Patient Data

Age: 26
Gender: Male
X-ray

Gross dilated gas filled small bowel down to the level of the ileum.

The large bowel is collapsed.

The small bowel is markedly dilated down to the distal ileum.

Transition point centrally down within the pelvis, approximately 10-20cm from the terminal ileum.

Small volume pelvic free fluid.  No free gas.

Annotated image

The transition point at the site of the adhesion is indicated (red arrows).

Case Discussion

A textbook example of a high grade adhesional small bowel obstruction.

A laparotomy was performed which identified an adhesive band causing obstruction at the level of the distal ileum consistent with the CT findings.

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Case information

rID: 52107
Published: 28th Mar 2017
Last edited: 28th Mar 2017
Inclusion in quiz mode: Included