Large bowel obstruction secondary to adhesive bands

Abstract

Large bowel obstruction (LBO) is most commonly due to malignancy, volvulus, hernia, diverticular disease and inflammatory bowel disease. LBO due to adhesions is unusual. A literature review was conducted which revealed that only a few such cases have been reported. We report two cases of LBO secondary to adhesions in patients, one with and one without a past abdominal surgical history. We highlight that while rare, the aetiology of LBO secondary to adhesions must be considered in the differential diagnosis in patients presenting with obstructive symptoms.

Large Bowel Obstruction

“…16 Adhesions can be congenital, idiopathic, or acquired. 17 Idiopathic adhesions can occur from various sources of abdominal inflammation, for example inflammation of appendices epiploicae or salpingitis. 17 Acquired adhesions occur as a result of the normal healing process after iatrogenic or traumatic insult.…”

“…17 Idiopathic adhesions can occur from various sources of abdominal inflammation, for example inflammation of appendices epiploicae or salpingitis. 17 Acquired adhesions occur as a result of the normal healing process after iatrogenic or traumatic insult. Inflammation can result in the colon being tethered to other segments of bowel or the abdominal wall which in turn can kink and obstruct the bowel during peristalsis.…”

Large Bowel Obstruction Caused by a Foreign Body

“…Less common causes include strictures (from inflammatory bowel disease, ischaemia and radiation), intussusception, adhesions (less than 1%) and faecal impaction. Pseudo-obstruction (Ogilvie's syndrome), a condition characterised by acute dilatation of the colon in the absence of mechanical obstruction, presents with similar clinical features to an organic obstruction with the same potential complications, but is usually associated with another illness [5][6].…”

Large bowel obstruction due to adhesion bands following right nephrectomy and transplanted pelvic kidney

“…These cases vary from presentation with obstructive symptoms as early as 6 months old to a 76‐year‐old woman with progressive obstruction over 1 month . There is also a case of an inflammatory band caused by ovarian cyst and possible salpingitis …”

“…There are several cases which report an intestinal obstruction following laparoscopic nephrectomy, several of which involve mesenteric herniation of small bowel . There are cases reported of adhesion bands causing LBO following appendicectomy, laparoscopic converted to open inguinal hernia repair and laparoscopic cholecystectomy …”