A case of adhesive small bowel obstruction with pelvic inflammatory disease due to Chlamydia trachomatis.

Lee, Ji Eun; Kim, Myounghwan; Choi, Hoon; Ko, Ji Kyung; Lee, Chulmin; Cho, Yongkyoon; Kim, Bokrin; Yang, Keunho; Kwon, Ji Eun

doi:2012.55.4.278

Case Report

Korean Journal of Obstetrics & Gynecology 2012;55(4):278-284.
DOI: https://doi.org/10.5468/KJOG.2012.55.4.278 Published online April 17, 2012.

A case of adhesive small bowel obstruction with pelvic inflammatory disease due to Chlamydia trachomatis.

Ji Eun Lee, Myounghwan Kim, Hoon Choi, Ji Kyung Ko, Chulmin Lee, Yongkyoon Cho, Bokrin Kim, Keunho Yang, Ji Eun Kwon

¹Department of Obstetrics and Gynecology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea. myankim@paik.ac.kr
²Department of Surgery, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.
³Department of Pathology, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea.

Abstract

A 17-year-old woman, who was hospitalized because of pelvic inflammatory disease due to Chlamydia trachomatis, developed emesis on 5th hospital day. On 7th day, vomiting and abdominal pain was aggravated. Plain radiography and contrast enhanced abdominopelvic computed tomography (CT) scan revealed small bowel obstruction with possible ischemic change at the level of the mid to distal ileum. Emergent exploratory laparotomy wad done and revealed adhesive band between small bowel mesentery and omentum, which resulted in closed loop and small bowel obstruction. Partial omentectomy, adhesive band adhesiolysis and incidental appendectomy was done. After surgery, the symptom was completely resolved with no further recurrence after outpatient department follow-up for 11 months. The present case calls for inclusion of abdominopelvic CT scan as well as plain radiography of the abdomen in the evaluation of pelvic inflammatory disease (PID) associated with emesis to detect bowel obstruction, rare sequlela of PID.

Key Words: Small bowel obstruction, Pelvic inflammatory disease, Chlamydia trachomatis