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Multifocal small bowel obstruction in an infant
Jamie E Anderson1, Erin G Brown1, Stephen K Greenholz1
1University of California Davis Medical Center, Sacramento CA, United States.
Insights
A 17-month-old girl experienced acute small bowel obstruction due to ingested rubber balls. This case highlights key clinical and imaging factors for diagnosing pediatric small bowel obstruction.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Radiology
Background:
- Acute small bowel obstruction is a surgical emergency in infants and children.
- Diagnosis can be challenging in young children, especially without a clear history.
- Foreign body ingestion is a common cause of gastrointestinal issues in this age group.
Observation:
- A 17-month-old girl presented with acute small bowel obstruction.
- Computerized tomography (CT) showed proximal jejunal obstruction with distal dilation and air-fluid levels.
- Initial imaging excluded malrotation, volvulus, and intussusception, leaving the diagnosis unclear.
Findings:
- Exploratory laparotomy revealed multiple rubber balls obstructing the small bowel.
- The foreign bodies were identified as the cause of the obstruction.
- Histopathological examination confirmed the nature of the foreign bodies.
Implications:
- This case underscores the importance of considering foreign body ingestion in pediatric small bowel obstruction.
- Radiologists and clinicians should maintain a high index of suspicion for unusual foreign bodies.
- Early surgical intervention is crucial for favorable outcomes in pediatric bowel obstruction.
Abstract:
This is a case report of an acute small bowel obstruction in a 17-month-old girl with no significant past medical history. Computerized tomography (CT) of the abdomen demonstrated complete obstruction at the proximal jejunum as well as perplexing dilation and air-fluid levels within the distal jejunum beyond the initial obstruction. Imaging demonstrated no evidence of malrotation, volvulus, or intussusception, but a clear diagnosis was not evident. Exploratory laparotomy was performed and multiple foreign bodies that appeared to be rubber balls were found within the small bowel. This case study identifies important clinical and radiologic considerations when assessing infants for small bowel obstruction.
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