Small bowel obstruction with fecalisation

Case contributed by Michael P Hartung


Abdominal pain. History of small bowel resection.

Patient Data

Age: 40 years
Gender: Male

Small bowel obstruction with transition point in the right lower quadrant at the site of enteroenteric anastomosis. Fecalization of several loops of distal small bowel content leading to the transition point. Mid through distal small bowel loops dilated up to 3.4 cm. Stomach is moderately distended. Several loops of proximal small bowel are not dilated.     

Case Discussion

Fecalized small bowel content can be very helpful to locate the site of obstruction, and often indicates a low-grade or developing obstruction, as there is enough time for increased resorption of water content to occur. In this case, the fecalized contents lead to the transition point, which is at the enteroenteric anastomosis and likely due to adhesions.

Patient was successfully managed with nasogastric decompression and slow advancement of diet.

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