Small bowel obstruction - adhesional

Case contributed by Dr Ian Bickle

Presentation

Distended abdomen. Nausea and vomiting. Bowel obstruction?

Patient Data

Age: 70 years
Gender: Female

Multiple dilated loops of gas filled small bowel.

Large bowel collapsed.

Right iliac stent.

The large bowel is moderately distended and fluid filled.

Small bowel faeces sign in the distal ileum, prior to an abrupt calibre change (transition point) 2-3cm from the ileocaecal valve.

The large bowel is collapsed.

No free gas.

Suprapubic catheter.  

Fatty liver. 

Case Discussion

This case is a nice example of a high grade adhesional distal small bowel obstruction. 

The 'hold up' is evident with the small bowel faeces sign and the abrupt transition point without any structural cause is classic of an adhesional small bowel obstruction.

This was confirmed at laparotomy.

PlayAdd to Share

Case information

rID: 50468
Case created: 7th Jan 2017
Last edited: 21st Jan 2017
Tag: rdgh
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.