Presentation
Right iliac fossa pain since 3 days; vomiting few episodes since 2 days; stool and flatus not passed since 2 days.
Patient Data
There are dilated small bowel loops measuring 4.3 cm at its maximum involving the jejunum and ileum. There is a transition point noted near the distal ileum beyond which the distal bowel loops are collapsed. There is no bowel wall thickening. Ileo-cecal junction appears unremarkable.
There is moderate free fluid within the peritoneal cavity.
Appendix is enlarged in size measuring 0.9 cm at its maximum diameter. There are surrounding few fat strandings in the right iliac fossa. However, appendiceal lumen appears intact with air noted within it. There is no appendicolith.
There are few hyperdense contents within the gallbladder lumen near its neck region suggesting sludge.
Few, oval shaped, well defined, homogeneously enhancing, lymph nodes are noted in the mesenteric region; one of them measures 0.8 x 0.5cm in size.
Case Discussion
This case is of small bowel obstruction with a transition point near terminal ileum which was found to have adhesive band during abdominal laparotomy.