Classic signs of closed loop bowel obstruction

Abstract

A 75-year-old man presented to this hospital with abdominal pain. The patient described the sudden onset of: left lower quadrant pain nine-out-of-ten in severity, associated with multiple episodes of bilious vomiting. The patient had not had a bowel movement in 4 days. Physical examination was notable for tenderness to palpation and guarding in the left lower quadrant. Computed tomography of the abdomen and pelvis without contrast material was completed, and demonstrated a closed-loop bowel obstruction involving an ileal loop (Figs. 1, 2). The patient underwent an exploratory laparotomy, which confirmed an ischemic closed-loop obstruction. A small bowel resection was performed (Fig. 3), and the patient recovered uneventfully.