Small bowel obstruction at a loop ileostomy stoma

Case contributed by Chris O'Donnell
Diagnosis certain

Presentation

Previous rectal perforation due to stercoral ulcer treated 7 days ago with loop ileostomy. Now abdominal distenson and nil ileostomy output ? obstruction

Patient Data

Age: 45 years
Gender: Female

Markedly dilated small bowel up to the loop ileostomy. The afferent portion of the loop ileostomy shows focal narrowing as it passes through the rectus abdominis muscle (arrow), the efferent portion being collapsed as it re-enters the peritoneal cavity

Case Discussion

This is an important case as it is relatively easy to relieve the obstruction by inserting a finger into the stoma and advancing a Foley catheter into the afferent loop. The swelling around the stoma will often settle after a few days and the ileostomy will function normally.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

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

 Thank you for updating your details.