Bowel obstruction secondary to urine retention

Case contributed by Heba Abdelmonem
Diagnosis probable

Presentation

Abdominal distension ? intestinal obstruction.

Patient Data

Age: 50 years
Gender: Female

Markedly distended urinary bladder reaches the level of L2 vertebrae with bilateral hydronephrosis and hydroureters. Markedly dilated small bowel loops, ileocecal junction, the right side of the colon and transverse colon where the large colon is markedly distended till a transitional zone is demonstrated at the level of the rectosigmoid junction being compressed by the markedly distended bladder against the patient's vertebral column. Abnormal reflux of the cecal content into the terminal ileum suggests colo-ileal reflux. No portal venous gas. 

Annotated image

Annotated images demonstrate the colonic zone of transition.

Case Discussion

The case demonstrates severe bowel obstruction with resultant ileocecal valve incompetence secondary to compression of the rectosigmoid junction against the vertebrae by a hugely distended bladder.

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