The compromised segment of small bowel is seen with the specimen uncoiled.
Surgeon: Phillip Perdue
Chief Resident: Allison Coste
Comment:
The optimal time to operate for complete small bowel obstruction is before bowel strangulates and dies (see small bowel obstruction). Resection of dead bowel increases morbidity and mortality. This patient evidenced signs of compromised bowel on presentation. The most common cause of small bowel obstruction is adhesions from previous surgery. However, in any patient with a history of colon carcinoma, recurrent disease should be high in the differential diagnosis until proven otherwise.
Reference:
Scoville, WA, in Cameron, JL, Current Surgical Therapy, 5th ed, Mosby, 1995: 100-104.