Small bowel obstruction attributed to adhesions

Case contributed by Dr Bruno Di Muzio

Presentation

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

Patient Data

Age: 64
Gender: Female

Distension of proximal small bowel loops (duodenum and jejunum) with abrupt transition to intestinal segment of normal caliber. Presence of small amount of free fluid in the peritoneum.

Annotated image

Annotated

Image demonstrates the region of transition between normal caliber 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. 

The diagnosis on imaging and in this case is made by excluding other causes of obstruction, usually in the setting of a surgical history of previous abdominal/pelvic surgery. 

The case was treated as such.

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Case information

rID: 14912
Case created: 4th Sep 2011
Last edited: 10th Aug 2017
Inclusion in quiz mode: Included

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