Closed loop small bowel obstruction

Case contributed by Ian Bickle


Previous colostomy for colorectal malignancy. Distended abdomen and vomiting.

Patient Data

Age: 60 years
Gender: Female

Left iliac fossa colostomy.

The small bowel is moderately dilated and fluided filled down the site of a small left inferior anterior abdominal wall hernia.

The hernia contains a very small segment ('knuckle') of ileum with dilatation of both the afferent and efferent loops.

No free fluid or free gas.

The solid organs are normal.

Case Discussion

In closed loop bowel obstruction two points along the course of a segment of bowel are obstructed at a single location, such as a hernia, thus forming a closed loop. Both the efferent and afferent loops will be dilated, as opposed to the single site cut off of typical bowel obstructions.

They account for a small percentage of bowel obstructions and is specific entity of small bowel obstruction.  There is a high chance of ischemia in the closed off segment of bowel.

This case was proven at surgery.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.