Small bowel obstruction due to tethering of bowel loops in Crohn disease

Case contributed by Dr Vikas Shah


Known Crohn disease with long-standing enterocutaneous fistula. Now has abdominal pain and vomiting.

Patient Data

Age: 40 years
Gender: Male

Multiple loops of small bowel, and the sigmoid colon, are tethered together deep to the anterior abdominal wall at the site of a cutaneous opening. There is no free fluid or abscess.

Case Discussion

Some of the consequences of trans-mural Crohn disease are illustrated here - enterocutaneous fistula formation and tethering together of multiple loops of bowel, in this case causing small bowel obstruction. Other organs can also become involved in the inflammatory "phlegmon", such as the urinary bladder. 

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