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Postgraduate Medical Journal 2002;78:630; doi:10.1136/pmj.78.924.630
Copyright © 2002 The Fellowship of Postgraduate Medicine.
Postgraduate Medical Journal 2002;78:630
© 2002 The Fellowship of Postgraduate Medicine

An interesting case of small bowel obstruction

The first 150 words of the full text of this article appear below.

Q1: What is the diagnosis?

This is a case of mechanical small bowel obstruction secondary to an enterolith/bezoar the likely source of which is jejunal diverticulosis

Q2 : What is the differential diagnosis?

This includes the various intraluminal causes of small bowel obstruction such as:

  • True foreign bodies: metallic, plastic.
  • Food bolus.
  • Gallstones.
  • Concretions.

Q3: What are the other possible complications of the primary disease of the small bowel?

The possible complications include:

  • Diverticulitis
  • Haemorrhage
  • Obstruction: 1. True obstruction due to enterolith, diverticulitis, adhesions associated with inflammation, volvulus about the adhesions, and intussuception. 2. Pseudo-obstruction or motility disorder.
  • Malabsorption due to stasis and bacterial overgrowth.
  • Fistulae.
  • Asymptomatic pneumoperitoneum.
  • Malignant tumours.

Q4: What are the possible treatment options?

The simplest surgical option for small or crushable enteroliths is to milk them distally into the caecum and allow them to pass naturally. If this is not possible, the treatment of this condition is an enterotomy to remove the enterolith with or without resection of the segment of small bowel involved with diverticulosis. Resection may be advocated if the diverticulosis is localised, and is recommended for the . . . [Full text of this article]


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An interesting case of small bowel obstruction
N Pranesh and K Mainprize
Postgrad. Med. J. 2002 78: 626. [Extract] [Full Text] [PDF]

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