Presentation
Abdominal pain, nausea.
Patient Data
Small to medium volume ascites. Swirling, edematous, and relatively hypoenhancing clusters of small bowel in the right abdomen. Associated vascular swirling and narrowing, particularly the SMV. Transitions in/out of this cluster can be identified next to each other. Many of the loops in this cluster have increased wall density (suggesting ischemia and hemorrhage). The terminal ileum and cecum are displaced into the left upper quadrant.
Case Discussion
Surgically confirmed closed loop small bowel obstruction with 220 cm of ischemic/hemorrhagic small bowel resected. Ischemia can be suspected based on the relatively increased thickness and density of the small bowel wall within the closed loop. This was caused by an adhesive band, which is the most common cause of closed-loop obstruction.
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