Closed loop small intestinal obstruction
Recurrent abdominal pain, increasing in severity over last few days.
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A closed loop obstruction is seen with marked dilatation of jejunal loops, however duodenum and ileum appeared normal in caliber. A characteristic 'whirlpool' sign is seen on axial CT images, with twisting of bowel loops and superior mesenteric vein left to the superior mesenteric artery. Mild bowel wall thickening is also seen in distal jejunum. In nutshell, small intestinal volvulus features are seen in case of closed-loop obstruction.
This is a typical closed-loop obstruction based on CT morphology.
Decompression was done by nasogastric tube, but patient could not be operated due to risks in pre-anesthetic work-up.