Kahyun Yoon-Flannery, DO, MPH, Christopher Falcon, DO, Anna Goldenberg-Sandau, DO, Michael J Sasso, DO
UMDNJ-SOM
Background Acute small bowel obstruction has been considered a relative contraindication for laparoscopic management in the past. Recent studies have demonstrated the utility of the laparoscopic management in such cases with promising results.
Case Presentation We are presenting a case study on an elderly patient who presented to our emergency department with nausea and vomiting and was found to have a small bowel obstruction with a possible metallic object in the mid-jejunal portion in the pelvis. We initially performed a diagnostic laparoscopy, which showed a metallic object consistent with a coin stuck in the wall of a jejunum and subsequently performed a resection of the segment. We were able to achieve a primary anastomosis at the resection sites using an Endo GIA stapler and reinforcing with a 3-0 interrupted silk stitch after bringing up the segments out through the port sites using a wound protector device.
Discussion Recent studies demonstrated a range in the success rates of laparoscopic management of an acute small bowel obstruction, citing morbidity rate as high as 15.5 percent with an early recurrence rate in as low as 2 percent. This case study demonstrates that the laparoscopic management of a previously contraindicated small bowel obstruction can be performed safely in the community hospital setting.
Session: Poster Presentation
Program Number: P225
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