Treatment: Postoperative complications

Postoperative bowel obstruction conservatively treated.

12 year old male with history of appendectomy two weeks prior was unable to tolerate advances in diet and complained of new onset left lower quadrant pain. CT scan, shown below, was obtained to differentiate between postoperative obstruction and abscess.

Figure 1. CT image of the midabdomen demonstrates multiple dilated, fluid-filled small bowel loops (DL). Note the decompressed colon (arrows).
Figure 2. CT image of the pelvis shows small bowel loops of lesser caliber within the pelvis (arrows) indicating more proximal obstruction. A dilated loop of more proximal small bowel (DL) extends into the pelvis.
The patient was placed on nasogastric tube suction to decompress the stomach and bowel loops. After several days, clinical symptoms had resolved, suction was discontinued, and the patient's diet was successfully advanced.

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