Presentation
Nausea, vomiting, constipation as well as distension since 3 days.
Patient Data
The jejunum and ileal loops are significantly dilated down to the distal ileum showing feces-like material. There is a transition point to normal caliber terminal ileum in the right lower abdominal region. No intra-abdominal free gas detected. Lymph nodes are not enlarged.
Conclusion: Findings are consistent with a small bowel obstruction with "small bowel feces sign" present. Transition point in the distal ileum where there is an abrupt transition of ileum caliber.
Case Discussion
"Small bowel feces sign" is characterized by the presence of particulate feculent material mingled with gas bubbles in the lumen of the small gut loop. It is the result of delayed intestinal transit and is believed to be caused by incompletely digested food, bacterial overgrowth, or increased water absorption of the distal small-bowel contents due to obstruction
The small bowel feces sign is most often present in distal small intestine loops. It is difficult to differentiate if from small bowel obstruction caused by a phytobezoar.