Small bowel obstruction attributed to adhesions

Case contributed by Dr Bruno Di Muzio

Presentation

Previous medical history of hysterectomy. She presents with diffuse abdominal distension and pain.

Patient Data

Age: 65 years
Gender: Female
CT

CT Abdomen and pelvis (selected images)

Distension of proximal small bowel loops (duodenum and jejunum) with an abrupt transition to an intestinal segment of normal calibre. Presence of small amount of free fluid in the peritoneum, but no free gas.

Annotated image

Annotated

Annotated images demonstrate the region of transition between normal calibre loop and distended loop (probably between the distal segment of the jejunum and proximal ileum).

Case Discussion

Small bowel obstruction accounts for 80% all mechanical intestinal obstruction; the remaining 20% result from large bowel obstruction.

An abdominal adhesion refers to a band of scar tissue (fibrous band or fibrous fatty tissue), most often occurring as a complication related to prior abdominal surgery. Adhesions interconnect loops of bowel or stick to the parietal peritoneum, mainly the abdominal wall and the sub-peritoneal organs. 

In this case, the diagnosis was made based on the imaging appearances and the clinical history of previous abdominal/pelvic surgery. 

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Case information

rID: 14912
Published: 4th Sep 2011
Last edited: 8th May 2018
Inclusion in quiz mode: Excluded

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