Closed loop small bowel obstruction in pregnancy (MRI)

Case contributed by Andrew Plumb
Diagnosis certain

Presentation

30/40 pregnant. Acute abdominal pain and vomiting.

Patient Data

Gender: Female

Free fluid throughout the abdomen and pelvis. Multiple fluid-filled dilated loops of small bowel clustered in the left upper quadrant, with beak-like abrupt transition points of two end of a long segment located in close proximity. Significant edema and engorgement of the associated mesenteric fat. Findings consistent with closed-loop small bowel obstruction, likely secondary to band adhesion. Non-distended large bowel.

Case Discussion

Following the MRI, the patient underwent a mini-laparotomy and the adhesion was divided and the small bowel was untwisted, and no resection was needed. They were discharged at 48 hrs with no further follow-up.

(Case uploaded with the assistance of Vikas Shah)

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