A Case Report on the Spontaneous Intraperitoneal Rupture of Urinary Bladder Presenting as Acute Intestinal Obstruction – Lessons Learnt

Acute intestinal obstruction is a common surgical emergency. Most of the time, the cause lies in the gastrointestinal track. A 19 year old boy presented with clinical features of acute intestinal obstruction and radiological features suggestive of large bowel obstruction was taken up for surgery. During evaluation we found extravasation of urine inside pelvic cavity. Exploratory laparotomy showed intraperitoneal rent in dome of urinary bladder with dense adhesion of omentum kinking the transverse colon causing acute intestinal obstruction. We were surprised to see the resolution of obstruction with excision of omental band. The bladder was repaired and he was relieved of the problem. This article is a rare example of nongastrointestinal cause for intestinal obstruction. Most of these cases are seen by a general surgeon in an emergency setting. Hence this report is to enlighten the medical caregivers about the existence of this rare entity

A Rare Case Report of Idiopathic Abdominal Cocoon Presenting as Acute Intestinal Obstruction-Management Challenges

The idiopathic variant of sclerosing Intraperitoneal fibrosis is a rare pathological entity causing intestinal obstruction. Even though it is described since the beginning of the last century, we are still clueless about the aetiology of this problem. The presentation is often confusing and the clinical and laboratory values will be not confirmatory to establish a diagnosis. A Contrast-enhanced CT scan is a vital investigation of choice. Here we discuss a case of intestinal obstruction with a preop diagnosis of internal herniation, which turned out to be a case of massive intraperitoneal fibrosis. The histopathology was not significant, and no secondary cause was identified. The case report throws wisdom into the existence of this entity and how with a CT scan we can suspect it before surgery. With adequate and meticulous enterolysis we can surgically rehabilitate these patients so that they can lead a normal life