Characteristics of ED Patients with CT-Proven Small Bowel Obstruction and Discordant Negative Plain Abdominal Radiography

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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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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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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Accuracy of Abdominal Radiography in Acute Small-Bowel Obstruction: Does Reviewer Experience Matter?

American Journal of Roentgenology ◽

10.2214/ajr.06.0817 ◽

2007 ◽

Vol 188 (3) ◽

pp. W233-W238 ◽

Cited By ~ 74

Author(s):

William M. Thompson ◽

Ramsey K. Kilani ◽

Benjamin B. Smith ◽

John Thomas ◽

Tracy A. Jaffe ◽

...

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Abdominal Radiography ◽

Acute Small Bowel Obstruction

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Abdominal Radiography Findings in Small-Bowel Obstruction

American Journal of Roentgenology ◽

10.2214/ajr.176.1.1760167 ◽

2001 ◽

Vol 176 (1) ◽

pp. 167-174 ◽

Cited By ~ 51

Author(s):

John C. Lappas ◽

Benedicto L. Reyes ◽

Dean D. T. Maglinte

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Abdominal Radiography

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Optimal Timing of First Abdominal Radiography after Gastrografin Administration for Small Bowel Obstruction

Journal of Surgical Research ◽

10.1016/j.jss.2020.06.053 ◽

2020 ◽

Vol 256 ◽

pp. 193-197

Author(s):

Omar Alnachoukati ◽

Mohamed Ray-Zack ◽

Sam Godin ◽

Taylor Apodaca ◽

Martin Zielinski ◽

...

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Bowel Obstruction ◽

Optimal Timing ◽

Abdominal Radiography

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Conventional Radiography and Ultrasonography in the Diagnosis of Small Bowel Obstruction and Strangulation

Acta Radiologica ◽

10.1177/02841851960371p138 ◽

1996 ◽

Vol 37 (1P1) ◽

pp. 186-189

Author(s):

J. Czechowski

Keyword(s):

Small Bowel ◽

Small Bowel Obstruction ◽

Acute Abdomen ◽

Bowel Obstruction ◽

Conventional Radiography ◽

Mechanical Obstruction ◽

Routine Examination ◽

Abdominal Radiography ◽

Linear Transducer ◽

One Year

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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