Closed loop small intestinal obstruction

Case contributed by Dr Praveen Jha


Recurrent abdominal pain, increasing in severity over last few days.

Patient Data

Age: 85 years
Gender: Male

A closed loop obstruction is seen with marked dilatation of jejunal loops, however duodenum and ileum appeared normal in caliber. A characteristic 'whirlpool' sign is seen on axial CT images, with twisting of bowel loops and superior mesenteric vein left to the superior mesenteric artery. Mild bowel wall thickening is also seen in distal jejunum. In nutshell, small intestinal volvulus features are seen in case of closed-loop obstruction.

Case Discussion

This is a typical closed-loop obstruction based on CT morphology.

Decompression was done by nasogastric tube, but patient could not be operated due to risks in pre-anesthetic work-up. 

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Case information

rID: 16156
Published: 23rd Dec 2011
Last edited: 4th Jan 2020
Inclusion in quiz mode: Included

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