Presentation
Abdominal distension and vomiting. History of small bowel resection for ileal atresia two weeks ago.
Patient Data
Abdominal radiographs after two and three weeks of surgery showing multiple dilated gas-filled bowel loops (likely small bowel). No gas in the rectum. No pneumoperitoneum.
Small calibre/unused colon. No focal abnormal narrowing or dilatation is seen in the colon. Reflux of contrast is noted into the normal calibre terminal ileum. The study also outlines a short-length focal narrowing/transition zone (likely at the site of previous surgical anastomosis) in the distal ileum, associated with abnormal dilatation of the proximal small bowel. No contrast extravasation or pneumoperitoneum is seen.
Annotated images of the large bowel enema showing a transition zone between the normal calibre terminal ileum and dilated proximal small bowel.
Histopathology report of the resected small bowel segment.
Case Discussion
Operation notes: Adhesions between the small bowel and abdominal wall. The previous anastomotic site was patent but showed diffuse narrowing and was associated with dilatation of the proximal bowel and collapse of the terminal ileum. Dilated bowel along with the narrowed anastomotic site was resected and sent for histopathology.
The patient is a known case of ileal atresia (rID-167041).
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