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◇◇◇A Case Of Subacute Small Bowel Obstruction (SBO)◇◇◇

Clinical History (Hx):~ 24 Years Female Patient presents with Intermittent abdominal pain (predominantly left lower abdomen)
Abdominal distension
Nausea with occasional vomiting
History suggestive of prior abdominal surgery.

Technique:~ Real-time transabdominal ultrasound examination performed using a curv and linear probe. Grayscale and limited peristaltic assessment done.

Findings:~ Multiple dilated small bowel loops are noted, predominantly involving the proximal ileum, located in the left lumbar region and left iliac fossa.
The maximum bowel loop diameter measures approximately 29 mm, suggestive of significant dilatation.
The dilated loops are filled with echogenic intraluminal contents (food residue).
Peristalsis appears sluggish, consistent with subacute obstruction.
A well-defined transition point is identified in the left paramedian infraumbilical region, beyond which the bowel loops appear collapsed.
No obvious mass lesion or hernia is identified at the transition site.
Findings are highly suggestive of a mechanical obstruction, most likely due to bowel adhesions.
No significant free fluid is noted in the abdomen.
No evidence of bowel wall thickening, pneumatosis, or portal venous gas on current examination.

Impression:~ Dilated proximal ileal loops (max diameter ~29 mm) with intraluminal food residue and a distinct transition point in the left infraumbilical region.
Findings are suggestive of Subacute Small Bowel Obstruction (SBO)
Most likely etiology: Post-surgical bowel adhesions.

Recommendations:~ Clinical correlation and surgical evaluation advised
Consider contrast-enhanced CT abdomen for further evaluation of transition point and cause
Monitor for signs of complication (strangulation/ischemia)

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