July 1977

Isolated Small Bowel Obstruction as the Presenting Feature of Colonic Disease

Author Affiliations

From the General Surgical Services, Massachusetts General Hospital, and the Department of Surgery, Harvard Medical School, Boston (Dr Warshaw), and the Department of Surgery, University of Connecticut Health Sciences Center, Hartford, Conn (Dr Welch).

Arch Surg. 1977;112(7):809-812. doi:10.1001/archsurg.1977.01370070023002

• Small intestinal obstruction without colonic dilation can be the mode of presentation in a variety of colonic diseases, including carcinoma, diverticultis, and colitis. Plain abdominal roentgenograms may lead the unwary physician into errors of diagnosis and treatment by suggesting primary small bowel disease. Barium enema examination of the colon will keep the wary physician out of such traps. We describe five patients with small bowel obstruction who had a variety of colonic diseases diagnosed by barium contrast studies. If the reason for intestinal obstruction is not apparent and the need for emergency surgery is not compelling, we recommend an immediate contrast study of the colon to aid in evaluating possible colonic pathology.

(Arch Surg 112:809-812, 1977)