Small bowel obstruction

Case contributed by Tom O'Graphy , 14 May 2015
Diagnosis certain
Changed by Tee Yu Jin, 4 Oct 2019

Updates to Study Attributes

Findings was changed:

Marked dilatation of the stomach and small bowel loops. Bowel wall thickening in left in left lower quadrant, at the transition transition area of dilated dilated and collapsed small bowel.

Mesenteric hyperemia and fluid infiltration of surrounding fat.

Small foci of gas around the the bladder, and also under peritoneum inside the bladder bladder. This is not typical for gastrointestinal gastrointestinal perforation.

No abnormalities in the pancreas, spleen, kidneys, adrenal glands or liver. No peritoneal effusion. ColonThe large bowel is normalnot dilated. There is an uncomplicateduncomplicated diverticulosis of the ascending and sigmoid colon.

Images Changes:

Image CT (C+ portal venous phase) ( update )

Description was removed:
CT scan directly with IV contrast

Image CT (Scout view lateral) ( update )

Description was removed:
CT scan localizer lateral view

Image CT (Scout view frontal) ( update )

Description was removed:
CT scan localizer front view, the tube comes from the gastric probe, placed after the ultrasound and before the CT scan.

Updates to Study Attributes

Findings was changed:

It seems there's noBedside ultrasound performed demonstrates anechoic area with particles and air bubbles with a back and forth movement (not visible on this still image) typical of small bowel obstruction on ultrasound. No free fluid aroundidentified within the liverPouch of Douglas or in the Morison's pouch.

Images Changes:

Image Ultrasound (RUQ view) ( update )

Description was removed:
Bedside ultrasound with portable device: not good evaluation of the liver but it seems there's no fluid around the liver or in the Morison's pouch

Image Ultrasound (Longitudinal) ( update )

Description was removed:
Bedside ultrasound: distended bladder

Image Ultrasound (central abdominal view) ( update )

Description was removed:
Bedside ultrasound: anechoic area with particles and air bubbles with a back and forth movement (not visible on this still image) typical of small bowel obstruction on ultrasound.

Updates to Study Attributes

Findings was changed:

Abdominal radiograph showing dilated dilated bowel in the lower lower abdomen. Crosstable projection further demonstrates multiple gas-fluid levels.

Images Changes:

Image X-ray (Supine) ( update )

Description was removed:
Abdominal radiograph (supine). Dilated bowel in lower abdomen

Image X-ray (Cross table lateral) ( update )

Description was removed:
Abdominal radiograph (cross table lateral). Multiple gas-fluid levels

Updates to Case Attributes

Age changed from 90 to 90 years.
Body was changed:

The findings are compatible with fibrous abdominal adhesion from aan older surgical intervention.

This woman was operated upon operated 10 years ago for another small bowel obstruction obstruction. She didn't remember if the last time she had similar pain she had similar dark-brown (possibly fecaloid fecaloid) vomiting.

This patient was been hospitalized and placed under aspiration precautions while waiting waiting for surgical intervention.

CT scan was ordered by the surgeon for preoperative evaluation (she has a normal renal function so IV contrast was used). As with many older people, the patient didn't complain very much about the pain even though her her abdomen was tense.

  • -<p>The findings are compatible with <a href="/articles/abdominal-adhesions">fibrous abdominal adhesion</a> from a older surgical intervention.</p><p>This woman was operated upon 10 years ago for another <a href="/articles/small-bowel-obstruction">small bowel obstruction</a>. She didn't remember if the last time she had similar pain she had similar dark-brown (possibly fecaloid) vomiting.</p><p>This patient was been hospitalized and placed under aspiration precautions while waiting for surgical intervention.</p><p>CT scan was ordered by the surgeon for preoperative evaluation (she has normal renal function so IV contrast was used). As with many older people, the patient didn't complain very much about the pain even though her abdomen was tense.</p>
  • +<p>The findings are compatible with <a href="/articles/abdominal-adhesions">fibrous abdominal adhesion</a> from an older surgical intervention.</p><p>This woman was operated 10 years ago for another <a href="/articles/small-bowel-obstruction">small bowel obstruction</a>. She didn't remember if the last time she had similar pain she had similar dark-brown (possibly fecaloid) vomiting.</p><p>This patient was been hospitalized and placed under aspiration precautions while waiting for surgical intervention.</p><p>CT scan was ordered by the surgeon for preoperative evaluation (she has a normal renal function so IV contrast was used). As with many older people, the patient didn't complain very much about the pain even though her abdomen was tense.</p>

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