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Age: 5

Sex: Female

Indication: Abdominal pain, history of gastroschisis and ischemic bowel resection

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Case #23


Findings

  • Multiple dilated small bowel loops with air-fluid levels on upright imaging
  • No evidence of free intraperitoneal air
  • No abnormal intraabdominal mass effect or calcification
  • Chain sutures overlie the central abdomen
  • No acute findings in the chest


Diagnosis

  • Small bowel obstruction

Sample Report

Multiple dilated small bowel loops with air-fluid levels on upright imaging, concerning for a small bowel obstruction with transition point possibly at the surgical anastomosis given the location of the dilated loops relative to the chain sutures.

No evidence of free intraperitoneal air.

No abnormal intraabdominal mass effect or calcification.

No acute findings in the chest.


Discussion

  • Small bowel obstruction in children beyond the neonatal period is uncommon, with some etiologies including intussusception, adhesions (in children with previous operations), and ingested foreign bodies
  • The etiology in this case was adhesions related to prior surgery
  • CT can be helpful to identify the level and potential cause for obstruction, but is not always necessary and was not performed in this case



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