0:00

Now let's bring up another similar study,

0:03

but a little bit different as well.

0:04

So here again, we have a patient

0:06

who has a small bowel obstruction.

0:08

You can see these dilated loops of small bowel

0:10

throughout the abdomen, but now we're seeing

0:12

that fecalization of multiple small bowel loops.

0:15

Also noticing here along the liver's edge, you

0:18

can see a small volume of ascites as well.

0:21

So when you come down, you're going to

0:22

be looking for the obstructive point.

0:24

You can see that there is abrupt narrowing

0:26

here in this level of the small bowel.

0:29

Where the small bowel goes from dilated and

0:30

feces-filled to abruptly decompressed.

0:34

So this is again, a small bowel obstruction.

0:36

I would call this a higher grade small bowel

0:38

obstruction given the degree of small bowel

0:41

feces sign, the dilated loops of small bowel,

0:45

the fact that there's much more mesenteric fluid

0:47

here, and that there's also free ascites as well.

0:50

So this is a simple obstruction 'cause it's

0:52

only a single point of obstruction, probably

0:54

secondary to an adhesion in the pelvis.

0:57

Resulting in at least moderate

0:59

to a high grade obstruction.

1:01

So this may be less likely to be treated

1:03

conservatively, but I think most of our small

1:05

bowel obstructions, at least they try an NG-tube

1:08

decompression and attempt at a conservative management.

1:11

But they should be wary of this patient and watch

1:14

them closely because of the degree of obstruction.

Case: High Grade Bowel Obstruction

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