CT of Acute Abdomen

Epigastric Pain series 7 EXPERT COURSE Answer [EE Case 34]

Strangulated obstruction with no necrosis












No liquid content in cecum (white arrowhead) in Fig.15 and Fig.16, massive ascites (reference mark in Fig.1, Fig.24 and Fig.25), mesenteric stranding (black arrowhead in Fig.13-Fig.16) and distended, mostly gasless small bowel located in dorsal side, 4 findings are highly suggestive of strangulated obstruction. On tracing starting from Fig.23, loops obstruct at J of Fig.13 and 15 of Fig.14 indicating closed loop obstructing at black arrow of Fig.13. There is a collapsed small bowel (SB), and circle number 14 of Fig.2 from circle number 1 of Fig.12 represent simple obstruction of oral side. Du:duodenum. In face of massive ascites, sufficient enhancement of wall manifests viable loops. Immediate surgery confirmed above findings with viable strangulation of 80cm jejunum by an adhesive band.














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