Small bowel obstruction due to encircling of fallopian tube: A curious case report

INTRODUCTION AND IMPORTANCE: Intestinal obstruction is a common surgical emergency encountered almost in every casualty. Though adhesions, hernias and malignancies are the common causes of obstruction, various articles describe unusual causes of intestinal obstruction which needs timely surgical interventions to prevent morbidity and mortality. CASE PRESENTATION: In this case report we present the history of a 50 year old sub-fertile woman who presented with features of intestinal obstruction and confirmed radiologically with both plain x-ray and computed tomography. After conservative management and as the imaging didn't show the cause of obstruction, exploratory laparotomy was performed. There we found have encircling of left fallopian tube around mid-ileum with gangrenous part. Left salphingectomy and bowel resection with side-to-side anastomosis resulted in a favorable outcome. CLINICAL DISCUSSION: Intestinal obstruction can compromise blood flow to bowel loops leading to gangrene, perforation and death. CONCLUSION: Awareness, early recognition and timely intervention in intestinal obstruction is mandatory to prevent poor outcomes, especially in cases of unknown cause and not responding to conservative management. The real surgical challenge is not the decision whether to perform surgery, but the decision when and how to perform it.