Closed loop obstruction

Closed loop obstruction is a form of mechanical bowel obstruction in which two points along the course of the bowel are obstructed at a single... 

Fig.5.4a-d. Complicatedhernia.aAfferentloop obstruction shows the transition between the dilated intraabdominal loop (BO) and collapsed loop in inguinal hernia (arrow), b Efferent loop obstruction shows dilated bowels in ventral hernia (BO) with transition between the dilated loop in hernia and collapsed intraabdominal loop at the neck of the sac (arrow), c Tensely distended loop is devoid of air in a ventral hernia due to closed loop obstruction, d Strangulated loop of bowel (BO) in a ventral hernia shows thick walls... 

Early diagnosis of small bowel volvulus is crucial for better outcome of management as it can prevent complications. The vascular occlusion can lead to ischaemia and gangrene of the bowel. The closed-loop obstruction may lead to tense disten-... 

Fig. 5.9a,b. Closed-loop obstruction in segmental small bowel volvulus, a The proximal dilated loops of bowel show intraluminal fluid with microbubbles of air seen as echogenic dots, b Section through the loops of closed loop show the lumen filled with... 

Volvulus of the caecum is torsion of the caecum around its own mesentery, which often results in a closed-loop obstruction. It can occur only in the small percentage (11-25%) of the population who have a developmental failure of peritoneal fixation with resultant increased mobility of the caecum (Montes and Wolf 1999). It accounts for 11% of all intestinal volvulus. It usually occurs in patients who are 30-60 years old. There may be history of previous abdominal surgery, violent cough, atony of the colon, extreme exertion, unpressurized air travel... 

Because of the retroperitoneal location of the duodenum and its close proximity to the pancreatic head, secondary inflammatory changes with oedema and mural thickening of the duodenal loop may result from adjacent acute pancreatitis (Fig. 9.11). Severe pancreatitis can also cause intramural duodenal hematoma (Abbas et al. 2002), and indeed in this situation thickening of the duodenal wall may lead to symptoms of bowel obstruction. Pancreatic pseudocyst following acute pancreatitis may also cause... 

---