title: Early diagnosis of bowel obstruction and strangulation by computed tomography in emergency department.
abstract: BACKGROUND
  Closed loop bowel obstruction is a specific type of mechanical obstruction with a high risk of strangulation and bowel infarction, especially in the small bowel. It is associated with a high mortality rate. Hence, it is important for emergency physicians to identify the presence of strangulation, while making the diagnosis of closed loop small bowel obstruction.
  
  
  METHODS
  We reported three patients with strangulated closed loop small bowel obstruction associated with severe abdominal pain, who had been treated at the emergency department. Urgent computerized tomography was performed in the patients.
  
  
  RESULTS
  Two patients were discharged with stable conditions, and one patient died after hemodialysis.
  
  
  CONCLUSIONS
  Urgent computerized tomography of the abdomen serves as an important diagnostic tool in view of its ability to detect the site, level and cause of obstruction along with the distinctive CT appearance of closed loop small bowel obstruction and signs of ischemia. Early definitive diagnosis will guide subsequent management and improve outcomes.
authors.affiliation: Department of Emergency Medicine, Singapore General Hospital, Singapore.
authors.forename: Sohil
authors.initials: S
authors.lastname: Pothiawala
authors.affiliation: Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
authors.forename: Apoorva
authors.initials: A
authors.lastname: Gogna
keywords: Closed loop small bowel obstruction; Computed tomography; Ischemia; Strangulation