Small bowel obstruction at a loop ileostomy stoma

Case contributed by Dr Chris O'Donnell

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
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 insertion of 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.

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Case information

rID: 29038
Case created: 28th Apr 2014
Last edited: 24th Jan 2016
Inclusion in quiz mode: Included

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