Intestinal ischemia secondary to closed loop obstruction

Case contributed by Dr Dalia Ibrahim

Presentation

Presented to emergency department with acute severe abdominal pain and vomiting.

Patient Data

Age: 20-year-old
Gender: Female

The small bowel loops at the right lumbar region appear clustered, having a radial orientation with a beak of mesenteric vessels converging toward a focus of torsion.

The bowel loops show diffuse mural thickening, with extensive congestion and smudging of the related mesentery. Findings are impressive of intestinal ischemia.

Short appendiceal stump is seen. Right iliac abdominal wall appendicectomy scar is noted. Right hypochondrial abdominal wall scar of prior surgical intervention for treatment of intestinal obstruction secondary to adhesions.

Mild pelvic ascites. Left ovarian corpus luteum cyst. 

 

Case Discussion

Upon further investigation the patient disclosed that she had underwent appendicectomy a few years ago followed by surgery for treatment of intestinal obstruction caused by adhesions.

The patient had surgery after this current CT study which confirmed intestinal ischemia caused by closed loop obstruction secondary to adhesions. Resection anastomosis was made.

The patient had a short and uncomplicated recovery.

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Case information

rID: 30782
Case created: 3rd Sep 2014
Last edited: 27th Oct 2017
Inclusion in quiz mode: Included

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