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5 replies

closed-loop obstruction.

K KSMember

I was trying to find my earlier post, where I had asked about severe gas and tummy ache. Pouchoscopy hadnt found anything, so after many months, the doc decided to get a CT Enterology (sp?). This is the result:

A focal region of narrowed small bowel connects to the abnormally distended bowel loop (images 30 and 31 of series 8040). This is suspicious for a closed-loop obstruction.

And does uterus have anything to do with these as my uterus also appears to be enlarged!

Should I be worried? what caused it and how can it be fixed and also prevented in future?

Last edited by KS
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SteveGSteveGMember

Is that narrowed section situated after the distended loop of the bowel? Was it called a stricture in the report (which may cause partial obstructions and bloatings)? Or is it just a minor narrowing?

I have a distended loop of the small intestine myself, up to about 8 cm which is more like a colons's diameter. I don't know for sure what caused it, either bloatings over the years or an obstruction I had in 2005. I've been feeling well during the last years, thanks to chronic antibiotics to treat chronic pouchitis.

I don't think your enlarged uterus is correlated to the bowel.

K KSMember

Not sure if this answers the question: IMPRESSION:
1. Postsurgical changes from total colectomy, proctectomy with ileoanal reservoir. A distended 11.6 x 7.4 x 5.8 cm dilated loop of small bowel in the central abdomen is suspicious for a closed-loop obstruction, connecting to a possible anastomotic stricture, slightly superior to the ileal reservoir.

SteveGSteveGMember

Sounds like the stricture is way above the pouch, but I can't tell if it is around the old stoma site (as they call it "anastomotic"). Anyway you should ask you GI doc or the doctor who did the CT scan what kind of measures he / she would advise.

A closed loop would mean a distended piece of small intestine between two narrowings that are close to each other. The report mentions only one stricture. And it would be interesting to know the residual diameter of the stricture, as it could cause partial obstructions that would relate to your symptoms (tummy ache and bloatings).

K KSMember
This is what my Gastro sent me. I am so pissed he is soo casual about it.
1. it took him 2+ years of my constant nagging of pain and bloating to finally get CT scan.
2. and then he forgets to add rectal contrast, which means I need to get the same scan again!
I feel we are just a number to these doctors, and not real human. Working on getting a new gastro if possible!
-----------------------------------------
I looked the CT over with a 2nd radiologist. I don't believe that this is a closed loop blockage.
I do believe it's an important finding - likely related to your symptoms. The most likely explanation is that the tip of the J pouch (the efferent limb) is narrowed and the portion above has become progressively dilated. Debris and bacteria can build up leading to symptoms like yours.
I'd favor a follow up CT with a different sort of contrast given both orally and rectally right before the exam. This will clarify the situation. If I'm correct, I'll refer you over to discuss with Dr. Shelton about whether a revision of the pouch (removal of the dilated portion) would be helpful.
In the (highly unlikely) situation that you develop severe abdominal pain, fever, etc., go to the ER. However, I don't believe the original interpretation is correct & this is unlikely to happen.
SteveGSteveGMember

It's always good to have a second opinion with such problems. I hope your 2nd scan will reveal more details.

Some more questions:

Have you yet tried antibiotics as suggested in some of your recent posts? They can help a lot with bacterial overgrowth and bloatings / aching.

Do your blood labs (CRP) show signs of inflammation?

Did your recent pouch scopes also cover the last part of the small intestine? My exams always reached 40...60 cm inside. And for some reason the small intestine was always found to be more inflammed than the pouch itself.

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Tags: closed-loop, obstruction, tummyache
Views: 377
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