Case report on adhesive intestinal obstruction secondary to aortofemoral bypass: Case report

Falousse Kabira

doi:10.58372/2835-6276.1193

Authors

Falousse Kabira Department of Visceral Surgical Emergency, Faculty of Medicine and Pharmacy, University Hospital Center Ibn Rochd, Hassan II University, Casablanca, Morocco

DOI:

https://doi.org/10.58372/2835-6276.1193

Keywords:

Laparotomy, Aortofemoral bypass, Small bowel Obstruction, Adhesive bands

Abstract

Introduction: Aorto-iliac occlusive disease is frequently treated by endovascular approach as a first option. But due to failure of revascularization or recurrence, aorto-femoral bypass surgery remains another therapeutic alternative; however, adhesive bowel obstruction may be one of its infrequent complications.

Case presentation: A 51 year old patient, operated for aorto-iliac occlusive disease one year ago, having benefited from aorto-bifemoral bypass surgery, then put on anticoagulants and anti-platelet aggregants, presented to the emergency room for an occlusive syndrome that had appeared for 3 days, The abdominal CT scan showed a bowel obstruction with a closed loop mechanism upstream of a stenosing digestive parietal thickening without any sign of suffering, presence of an effusion, presence of a sub-renal aorto-femoral birth: He was admitted to our hospital and underwent an exploratory laparotomy.

Discussion: Adhesive bowel obstruction secondary to aorto-bifemoral bypass surgery is a rare complication. The possible mechanism may be caused by damage to the peritoneum and its microvasculature resulting in the release of a serosanguineous exudate that forms a fibrinous band connecting adjacent organs or injured serous membranes. A multidisciplinary approach is needed to manage laparotomy complications; however, identification of patients at high risk of these complications is essential at the time of the initial evaluation by the vascular surgeon.

Conclusion: A high index of suspicion for adhesive bowel obstruction is key to prompt diagnosis and treatment.

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