Adhesional small bowel obstruction

Case contributed by Dr Ian Bickle

Presentation

Distended abdomen. Appendicectomy 18 months prior.

Patient Data

Age: 26
Gender: Male
Modality: X-ray

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

The large bowel is collapsed.

Modality: CT

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.

Modality: 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
Case created: 22nd Mar 2017
Last edited: 28th Mar 2017
Inclusion in quiz mode: Included

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