Strangulating bowel obstruction

Strangulating or strangulated bowel obstruction refers to ischemia and/or infarction of an obstructed loop of bowel. It is most commonly seen in the setting of closed loop obstruction.

Epidemiology

Strangulation complicates ~15% (10-23%) of bowel obstructions .

Pathology

Strangulation can be caused by :

• adhesional small bowel obstruction
• internal and external hernias
• volvulus
• intussusception

Radiographic features

CT

The most specific finding of a strangulated bowel loop is reduced mural enhancement (~95%) and the most sensitive finding is mesenteric fluid (~90%) .