Small bowel obstruction - string of pearls sign

Case contributed by Maulik S Patel


Vomiting for 2-3 days. P/H/O two laparotomies

Patient Data

Age: 65 years
Gender: Male

Multiple air-fluid levels of small bowel morphology, in favor of small bowel obstruction. String of pearls sign present favor fluid distended loop.

Gas in the peripheral part of right lobe liver in portal venous branches demonstrating portal venous gas. Vascularity was present in dilated small bowel. A point of transition from dilated to collapsed loop was noted just below umbilicus. No mass could be localized here.

Case Discussion

Surgery after 1 hour confirmed findings of small bowel obstruction. Bowel was viable. An adhesion band was present at the point of transition, which was then released.

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