Gut can get obstructed in four ways; simple gut obstruction, closed loop obstruction
, strangulated and incarcerated gut obstruction.
Ileosigmoid knotting: a rare but treacherous cause of closed loop obstruction
. Am Surg.
We present a case in which a transverse colon epiploic appendage adhesion to the ascending colon mesentery resulted in a closed loop obstruction
mimicking a pericecal internal hernia.
The median time interval for visceral complication was reported to be seventeen months (varying from four weeks to thirteen years).9 Medical literature mentions one case of a migrated IUCD which, after 31 years of insertion, had become embedded in the omentum, and each of the two "arms" of the coil had entered into the lumen of mid ileum, giving rise to a closed loop obstruction
.9 Another case report of an unusual complication of the IUCD is in which the device perforated the uterus and migrated to the ileum but the IUCD string was still visible per vaginum.10
A portion of small bowel usually herniates through that ring or knot forming a closed loop obstruction
with or without strangulation.
Afferent loop obstruction is a specific form of closed loop obstruction
with the proximal component being the surgically closed-off duodenal stump (Figs 4 and 5), and the distal/downstream obstruction due to a variety of causes.
At laparotomy however, the caecum was noted to be herniating through the foramen of Winslow causing closed loop obstruction
. It could not be reduced by gentle traction, so the lesser sac was opened up and the caecum decompressed with a small enterotomy and suction to allow reduction.
Because of a competent ileocaecal valve and the resultant closed loop obstruction
, a perforation of the caecum had occurred accounting for the free peritoneal air on radiographs.
(19) The ABC Classification System differentiates the 3 types of SBO based on the point of obstruction relative to the JJ anastomosis: Type A is an obstruction above the JJ anastomosis with a dilated A-limb, Type B is an obstruction at or above the JJ anastomosis with a dilated B-limb and excluded stomach (closed loop obstruction
with high risk of perforation) (Figure 9), and Type C is an obstruction at the level of the common small bowel channel distal to JJ anastomosis with dilatation of both the A and B-limbs.
INTRODUCTION: The term "volvulus" originates from Latin volvere, "to twist." Volvulus occurs when a segment of the alimentary tract twists on its mesenteric axis with a greater than 180-degree rotation, producing closed loop obstruction
of intestinal lumen and mesenteric vessels, possibly leading to ischemia and gangrene.
We were not able to exclude closed loop obstruction
We report an unusual case of intestinal obstruction in a 23 year old male patient who was found to have an ACB forming a loop around the jejunum (Fig-1) and causing closed loop obstruction
. This band was arising from the treitz ligamentum and looping around the jejunum, ending at the root of mesentery.