An Atypical Presentation of a Small Bowel Obstruction in a Young Woman with a Congenital Omental Defect.

INTRODUCTION Acute small bowel obstruction (SBO) is a common surgical emergency in which the normal flow of intraluminal intestinal contents is interrupted.1 The two most common etiologies for SBO are postoperative adhesions and hernias; additional risk factors include tumors, foreign body ingestion, and inflammatory bowel diseases. Prolonged obstruction can lead to bowel dilatation proximal to the obstruction, coupled with edematous bowel wall and loss of normal absorptive functions.2 If untreated, SBO can progress to compromised intestinal perfusion, causing perforation, infection, and death; up to 42% of SBO are complicated by ischemia with significantly increased mortality.3-4 Initial symptoms include periumbilical cramping, nausea, vomiting, obstipation and abdominal distention, while sudden onset of sharp, focalized abdominal pain is suggestive of peritoneal irritation secondary to acute perforation.5-6