Contribution of laparoscopy in small bowel obstruction: Report on two rare causes of small bowel obstruction

Abstract

Abstract Introduction Bowel obstruction occurs when the normal flow of intraluminal content is interrupted. The most common cause of small bowel obstruction is adhesion but other rare causes of intestinal obstruction have also been reported as fecolith, foreign body or bezoar, GIST, and abdominal cocoon. Laparoscopy as diagnostic as well as therapeutic tool in small bowel obstruction seems to be useful. Methods We described two rare causes of intestinal obstruction. The aim of the present article is to stress the role of laparoscopy associated with computed tomography (CT) in diagnostic confirmation of causes of intestinal obstruction as well as reasons for conversion. We also reviewed the relevant published literature. Result CASE 1: A 63-year-old female presented with history of recurrent episodes of pain in left side of abdomen for 1 year. Contrast Enhanced Computed Tomography (CECT) showed rounded radiopaque foreign body in distal jejunum. Laparoscopic adhesiolysis and reduction of hernial content were done. Laparoscopic surgery converted to open for removal of foreign body and hernioplasty. CASE 2 64 year elderly male presented with history of intermittent episodes of colicky pain in periumbilical region for 1 month. CECT abdomen showed abdominal cocoon. Pneumoperitoneum access was not succeeded, thus exploratory laparotomy and adhesiolysis was done. Conclusion In small bowel obstruction, diagnostic laparoscopy has to be done for confirmation of diagnosis and if possible to release the cause of obstruction, but conversion to open by giving either small incision or exploratory laparotomy should be the choice to completely remove the cause for the further prevention of recurrence and complications.