Presentation
Distended abdomen. Appendectomy 18 months prior.
Patient Data
Gross dilated gas filled small bowel down to the level of the ileum.
The large bowel is collapsed.
The small bowel is markedly dilated down to the distal ileum.
Transition point centrally down within the pelvis, approximately 10-20cm from the terminal ileum.
Small volume pelvic free fluid. No free gas.
The transition point at the site of the adhesion is indicated (red arrows).
Case Discussion
A textbook example of a high grade adhesional small bowel obstruction.
A laparotomy was performed which identified an adhesive band causing obstruction at the level of the distal ileum consistent with the CT findings.