Matted Small Bowel

Bowel ischemia and bowel necrosis were more frequent findings with adhesive bands than with matted adhesions p 0 011 and p 0 049 respectively.

Matted small bowel.

Small bowel obstruction sbo accounts for 12 16 of emergency surgical admissions 1 and 20 of emergency surgical procedures. A higher incidence of small bowel feces sign was found in patients with matted adhesions p 0 014 than in patients with adhesive bands figs. Adhesions are by far the most common cause explaining 60 70 of all cases of sbo 2. 4 even with the advent of laparoscopic surgery intra abdominal adhesions remain a significant cause of sbo accounting for 65 of cases among other etiologies.

The central position of the abscess contained thickened small bowel that macroscopically did not look typical of malignancy. Adhesions causing sbo are classified as either matted adhesion. The location in the pelvis of the adhesive structure p 0 039 and a higher rate of accidental bowel perforation p 0 031 were associated with matted adhesions. A small bowel feces sign was present in 13 of 21 62 cases of sbo secondary to matted adhesions and 13 of 46 28 cases of sbo from adhesive bands.

5a 5b and 5c. The patient underwent an emergency laparotomy where he was found to have a 65 cm area of small bowel matted together with an intra loop abscess 60 cm upstream from the ileocaecal valve. The small bowel feces sign was more frequently seen in cases of sbo from matted adhesions p 0 014. Diagnosis of adhesive sbo however remains challenging.

Small bowel obstruction sbo remains a leading reason for emergency room visits inpatient admissions and emergent surgery in the united states 1. Adhesive small bowel obstruction sbo is a common cause of abdominal pain after surgery or peritonitis. 2 due to the possible risk of bowel ischemia or perforation urgent evaluation is necessary. 3 emergent surgery is necessary for patients with clinical or radiological signs suggestive of bowel ischemia.

The small bowel feces sign was more frequently seen in cases of sbo from matted adhesions p 0 014.