Closed loop small bowel obstruction

Discussion:

The patient proceeded to surgery immediately. Adhesions were found and ileum was resected.

PATHOLOGY: Macroscopically the mucosal folds were attenuated and the mucosa dusky with exudate. The bowel wall was up to 7mm thick and the serosa was dark brown to grey. Microscopically the sections showed ulceration and hemorrhage. No necrosis. Abundant acute inflammation. The submucosa was edematous with inflammatory changes. The blood vessels were congested. Diagnosis: Acute ischemia with hemorrhage. The resection margins are viable.

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