Diagnosis- Small Bowel Obstruction

Procedure -Exploratory laparotomy, lysis of adhesions, a previous ileocolic resection anastomosis and distal small bowel resection with a primary anastomosis

Procedure -A midline incision was made from the pubic symphysis to approximately 5 cm above the umbilicus. There were some adhesions that were taken down to the anterior abdominal wall .There was a loop of small bowel that was looped on itself and stuck to mesentery . The mesentery was thick, but not inordinately so that the loop of small bowel was then taken down . Dissection then was carried from the anastomosis. The transverse colon was the dissected around to the anastomosis . There was a large area of phlegmonous tissue proximal to the anastomosis . This was dissected free and then resected , however , this left a 4 cm piece of bowel proximal to the anastomosis to ensure viability that was resected as well. Once this was done , hemostasis was assured. A side -to side ileocolic anastomosis was fashioned. The common enterotomy was closed with a stapler and over sewn with aeries of sutures.

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