Adhesional small bowel obstruction
RTA with laparotomy several years prior. A short history of a distended abdomen, nausea and now vomiting.
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Moderately dilated fluid-filled small bowel down to the level of the proximal ileum (in the left iliac fossa) where there is an abrupt transition point.
The mid and distal ileum is collapsed. Normal calibre large bowel.
A small volume of free fluid in the upper abdomen and pelvis. No free gas.
Fatty paraumbilical hernia.
Solid organs of the upper abdomen normal.
A good example of an adhesional small bowel obstruction with a well identified, traceable transition point and absence of an alternative cause like a mass, hernia or intussusception.