Abstract
A 70-year-old woman was admitted to our hospital with abdominal pain after pretreatment for colonoscopy. The patient had no history of undergoing abdominal surgery. There was mild tenderness in the right lower quadrant of abdomen. A diagnosis of small bowel obstruction was made upon abdominal CT findings and conservative treatment by placing an ileus tube was started. Since no symptomatic remission was gained, we decided to perform surgical treatment. On abdominal surgery we saw a band stretching from the tip of an epiploic appendage of the ascending colon to the retroperitoneum, where a small bowel had been strangulated in the band formation. Removal of the funicular structure during surgery resulted in an improvement in color of the small intestine, and peristalsis could be confirmed as well. We diagnosed the case as strangulated ileus without having bowel necrosis. Cases of strangulated ileus in patients without a past history of abdominal surgery are rare. This case should remind us that even a negative past history of abdominal surgery dose not exclude the possibility of a strangulated ileus which requires sufficient observation and mandates early surgical intervention.
