Accuracy of Plain Abdominal Radiography in the Differentiation between Small Bowel Obstruction and Small Bowel Ileus in Acute Abdomen Presenting to Emergency Department

Ninety-six patients, 45 men and 51 women (mean age 39 years, range 13–90 years), with clinically acute abdomen were examined by conventional abdominal radiography and ultrasonography during a period of one year. Ultrasonography was performed with a linear transducer, which permitted study of morphology and motility of small bowel loops: distention, paralysis, intramural thickening, and extraluminal fluid. Nineteen cases of mechanical obstruction (9 simple and 10 of strangulation type) were observed. In the strangulation group ultrasonographic findings were positive in 91% whereas conventional radiography solely was positive in 30%. In the simple obstruction, 89% and 78%, respectively, were correctly diagnosed by the 2 techniques. Ultrasonography is recommended as a routine examination beside conventional abdominal films in acute abdomen.

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An Unusual Cause of Small Bowel Obstruction in a Child: Ingested Rhubarb

Case Reports in Surgery ◽

10.1155/2013/497214 ◽

2013 ◽

Vol 2013 ◽

pp. 1-2 ◽

Cited By ~ 2

Author(s):

Miguel Glatstein ◽

Dana Danino ◽

Ayelet Rimon ◽

Sergei Keidar ◽

Dennis Scolnik

Keyword(s):

Computed Tomography ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Exploratory Laparotomy ◽

Acute Intestinal Obstruction ◽

Foreign Material ◽

Abdominal Radiography ◽

Plain Abdominal Radiography ◽

Fluid Levels

Small bowel obstruction is rarely caused by bezoars concretions formed from undigested foreign material in the gastrointestinal tract. An important cause of bezoars is phytobezoars, formed from vegetables or fruits. A four-year-old boy presented to our emergency department with symptoms of acute intestinal obstruction. Upright plain abdominal radiography revealed multiple air fluid levels. Ultrasound showed no abnormalities, and because of worsening symptoms computed tomography of abdomen was performed. It showed intraluminal obstruction of the terminal ileum. Exploratory laparotomy revealed a phytobezoar consisting of undigested rhubarb. The mass was milked through the large bowel and out the anus. Although rare in humans, bezoars are a well-documented cause of small bowel obstruction and should be considered when intraluminal bowel obstruction occurs. Bezoars causing small bowel obstruction may require surgical treatment.

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An Uncommon An Uncommon Cause of Acute Abdomen in Underprivileged Communities

Journal of Case Reports in Medicine ◽

10.25149/jcrm.v8i2.175 ◽

2019 ◽

Vol 8 (2) ◽

Author(s):

David Muchuweti ◽

Hopewell Mungani ◽

Farai Mahomva ◽

Edwin Gamba Muguti ◽

...

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Acute Abdomen ◽

Bowel Obstruction ◽

Bowel Wall ◽

Haemodynamic Instability ◽

Small Bowel Volvulus ◽

General Surgeons ◽

Heavy Infestation ◽

Emergency Abdominal Surgery

Oftentimes general surgeons working in poorly resourced communities carry out emergency abdominal surgery in patients with acute abdomen with no definitive preoperative diagnosis. The definitive diagnosis is made at laparotomy. Perforated small bowel obstruction secondary to heavy Infestation with Ascaris Lumbricoides brings a number of intraoperative challenges requiring correct intraoperative surgical management decisions. We present a case of a 17 year-old patient who was admitted with a diagnosis of small bowel obstruction who at laparotomy was found to have perforated gangrenous small bowel volvulus with heavy worm load visible through the bowel wall. Because of faecal peritoneal contamination and haemodynamic instability she underwent a two staged procedure with good outcome.

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Small Bowel Obstruction Induced by Concurrent Postoperative Intra-Abdominal Adhesions and Small Bowel Fecal Materials in a Young Dog

Veterinary Sciences ◽

10.3390/vetsci8050083 ◽

2021 ◽

Vol 8 (5) ◽

pp. 83

Author(s):

Jae-Eun Hyun ◽

Hyun-Jung Han

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Surgical Intervention ◽

Gastrointestinal Symptoms ◽

Exploratory Laparotomy ◽

Abdominal Adhesions ◽

Abdominal Radiography ◽

Foreign Body Removal ◽

Small Intestinal

A 7-month-old neutered male poodle dog presented with general deterioration and gastrointestinal symptoms after two separate operations: a jejunotomy for small-intestinal foreign body removal and an exploratory laparotomy for diagnosis and treatment of the gastrointestinal symptoms that occurred 1 month after the first surgery. The dog was diagnosed as having small-bowel obstruction (SBO) due to intra-abdominal adhesions and small-bowel fecal material (SBFM) by using abdominal radiography, ultrasonography, computed tomography, and laparotomy. We removed the obstructive adhesive lesion and SBFM through enterotomies and applied an autologous peritoneal graft to the released jejunum to prevent re-adhesion. After the surgical intervention, the dog recovered quickly and was healthy at 1 year after the surgery without gastrointestinal signs. To our knowledge, this study is the first report of a successful treatment of SBO induced by postoperative intra-abdominal adhesions and SBFM after laparotomies in a dog.

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Peer review report 1 on “Emergency department CT scan findings do not predict outcome of nonoperative management in small bowel obstruction”

International Journal of Surgery ◽

10.1016/j.ijsu.2016.01.057 ◽

2016 ◽

Vol 25 ◽

pp. 89

Author(s):

Tani Fasih

Keyword(s):

Emergency Department ◽

Small Bowel ◽

Ct Scan ◽

Small Bowel Obstruction ◽

Peer Review ◽

Bowel Obstruction ◽

Nonoperative Management

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Small bowel obstruction, volvulus, or both? Small bowel obstruction findings seen on emergency department POCUS ultrasound with subsequent volvulus diagnosed by CT

Visual Journal of Emergency Medicine ◽

10.1016/j.visj.2021.101166 ◽

2021 ◽

Vol 25 ◽

pp. 101166

Author(s):

Emmanouil Kiriakopoulos ◽

Diana Mora-Montero

Keyword(s):

Emergency Department ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction

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An interesting case of left paraduodenal hernia.

The Professional Medical Journal ◽

10.29309/tpmj/2021.28.05.4648 ◽

2021 ◽

Vol 28 (05) ◽

pp. 755-758

Author(s):

Sahar Saeed ◽

Abeera Butt ◽

Syed Asghar Naqi ◽

Muhammad Mohsin Ali

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Interesting Case ◽

Paraduodenal Hernia ◽

Absorbable Suture ◽

Internal Hernias ◽

Plain Abdominal Radiography ◽

History Of ◽

Operative Recovery

Paraduodenal fossa hernias (PDFHs) represent 53% of all congenital internal hernias and 0.2-0.9% of all small bowel obstructions. Most of these hernias are diagnosed incidentally on laparotomy, and carry up to 50% lifetime risk of development of small bowel obstruction. We present our experience in diagnosing and treating a case of a massive left paraduodenal fossa hernia in a 17 year male, containing over 30% of the small bowel (jejunum and ileum), presenting with a history of recurrent incomplete small bowel obstruction. Plain abdominal radiography showed distended loops of jejunum and few air fluid levels. After laparotomy and identification of hernia, small gut was reduced and examined, which was found to be structurally and functionally intact with normal vascularity. The defect was closed with continuous absorbable suture (Vicryl 2-0) sparing the inferior mesenteric vessels. Patient’s post-operative recovery remained uneventful and he was discharged on 4th post-operative day.

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A Prospective, Multicenter Evaluation of Point‐of‐care Ultrasound for Small‐bowel Obstruction in the Emergency Department

Academic Emergency Medicine ◽

10.1111/acem.13713 ◽

2019 ◽

Vol 26 (8) ◽

pp. 921-930 ◽

Cited By ~ 8

Author(s):

Brent A. Becker ◽

Shadi Lahham ◽

Mark A. Gonzales ◽

Jason T. Nomura ◽

Michelle K. Bui ◽

...

Keyword(s):

Emergency Department ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Point Of Care ◽

Point Of Care Ultrasound

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Endometriosis of the appendix causing small bowel obstruction in a virgin abdomen

BMJ Case Reports ◽

10.1136/bcr-2019-230496 ◽

2019 ◽

Vol 12 (7) ◽

pp. e230496 ◽

Cited By ~ 1

Author(s):

Joseph Do Woong Choi ◽

Michael Yunaev

Keyword(s):

Emergency Department ◽

Abdominal Pain ◽

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Oestrogen Receptor ◽

Surgical Intervention ◽

Prior History ◽

Good Recovery ◽

History Of

A 29-year-old, otherwise well, nulligravid woman presented to the emergency department with 1-day history of generalised abdominal pain and vomiting. She had similar symptoms 6 months prior following recent menstruations, which resolved conservatively. She had no prior history of abdominal surgery or endometriosis. CT scan demonstrated distal small bowel obstruction. A congenital band adhesion was suspected, and she underwent prompt surgical intervention. During laparoscopy, a thickened appendix was adhered to a segment of distal ileum. There was blood in the pelvis. Laparoscopic adhesiolysis and appendicectomy were performed. Histopathology demonstrated multiple foci of endometriosis of the appendix with endometrial glands surrounded by endometrial stroma. Oestrogen receptor and CD10 immunostains highlighted the endometriotic foci. The patient made a good recovery and was referred to a gynaecologist for further management.

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