Large Bowel Obstruction Caused by Adhesions without Previous Abdominal Surgery: Two Case Reports|
Munyika, A.A.; Muguti, E. & Muchuweti, D.
Background: Large bowel obstruction is rarely caused by adhesions. To our knowledge, the few
cases reported in literature are secondary to previous abdomino-pelvic surgery, and are in
Case Reports: We report two cases of large bowel obstruction due to adhesions in males with no
previous abdominal surgery. The first case was a 73 years old male previously well, who
presented with a one week history of abdominal colicky pain with nausea. Initially this patient
was thought to have symptomatic gallstones as a result of an ultrasound scan report.
Consequently, a decision to take the patient for laparoscopic cholecystectomy was reached. Due
to difficulties in achieving penumoperitoneum, a laparotomy was done; the patient was found to
have a fibrous band across transverse colon causing obstruction. The second case was a 61 years
old male, known diabetic and hypertensive, who presented with epigastric pain, nausea,
vomiting and constipation. Abdominal X-rays demonstrated large bowel obstruction. At
laparotomy, this patient was found to have adhesions causing sigmoid colon obstruction.
Conclusion: In this paper, we demonstrate the rarity of large bowel obstruction secondary to
adhesions especially in a virgin abdomen, emphasize the importance of good radiological
expertise, and highlight the need to consider adhesions as a very rare but possible cause of large