Presentation
Distended abdomen. Nausea and vomiting. Bowel obstruction?
Patient Data
Age: 70 years
Gender: Female
From the case:
Small bowel obstruction - adhesional
Frontal
Multiple dilated loops of gas filled small bowel.
Large bowel collapsed.
Right iliac stent.
From the case:
Small bowel obstruction - adhesional
Axial C+ portal venous phase
The small bowel is moderately distended and fluid filled.
Small bowel feces sign in the distal ileum, prior to an abrupt caliber change (transition point) 2-3cm from the ileocecal 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 feces sign and the abrupt transition point without any structural cause is classic of an adhesional small bowel obstruction.
This was confirmed at laparotomy.
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