Location
Suwanee, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
Introduction: Small bowel obstruction (SBO) is most commonly caused by postoperative adhesions, hernias, or malignancy. While adhesions typically arise from prior abdominal surgeries, gynecologic inflammatory conditions represent a rare but important etiology. Salpingitis, a manifestation of pelvic inflammatory disease (PID), can lead to pelvic adhesions but is an uncommon cause of mechanical SBO. Recognition of gynecologic sources of SBO is important for proper management and timely surgical intervention. We present a case of acute salpingitis resulting in adhesive band formation between the fallopian tube and the sigmoid colon, leading to mechanical SBO requiring operative management.
Case Presentation: We report the clinical course of a 48-year-old female who presented with acute abdominal pain, nausea, and vomiting. Her evaluation included laboratory testing, abdominal radiography with contrast, and computed tomography (CT) of the abdomen and pelvis. Small bowel radiography with contrast demonstrated delayed transit. CT imaging revealed persistent small bowel distention with a transition point in the distal small bowel, suggestive of SBO. Given concern for mechanical obstruction and persistent symptoms without improvement, exploratory laparoscopy was performed with intraoperative gynecologic consultation. Adhesiolysis, left salpingectomy, and oophorectomy were completed. The patient was subsequently monitored postoperatively.
Results: Imaging revealed dilated small bowel loops with a transition point and delayed contrast transit, consistent with SBO. Laparoscopic evaluation demonstrated extensive small bowel dilation with a transition point in the left lower quadrant caused by an adhesive band originating from a markedly inflamed and edematous left fallopian tube. The adnexa appeared dark red with surrounding old blood and fungating inflammatory changes, raising concern for possible gynecologic malignancy. Adhesiolysis was performed, and due to gross adnexal pathology, a left salpingo-oophorectomy was completed following intraoperative OB-GYN consultation. Final pathology demonstrated acute salpingitis with congestion and inflammation, without evidence of malignancy.
Conclusion: Adhesive disease remains the leading cause of small bowel obstruction (SBO), with most cases related to prior abdominal surgery. Gynecologic pathology is a less commonly recognized source of adhesive obstruction. This case underscores the importance of considering gynecologic etiologies in the differential diagnosis of SBO in female patients, even decades after tubal ligation. Acute salpingitis can lead to inflammatory adhesive band formation resulting in bowel obstruction and may closely mimic malignancy intraoperatively. Awareness of gynecologic inflammatory sources of SBO can facilitate timely recognition, interdisciplinary management, appropriate surgical decision-making, and prevention of delays in definitive treatment.
Embargo Period
6-1-2026
Included in
Acute Salpingitis Presenting as Small Bowel Obstruction
Suwanee, GA
Introduction: Small bowel obstruction (SBO) is most commonly caused by postoperative adhesions, hernias, or malignancy. While adhesions typically arise from prior abdominal surgeries, gynecologic inflammatory conditions represent a rare but important etiology. Salpingitis, a manifestation of pelvic inflammatory disease (PID), can lead to pelvic adhesions but is an uncommon cause of mechanical SBO. Recognition of gynecologic sources of SBO is important for proper management and timely surgical intervention. We present a case of acute salpingitis resulting in adhesive band formation between the fallopian tube and the sigmoid colon, leading to mechanical SBO requiring operative management.
Case Presentation: We report the clinical course of a 48-year-old female who presented with acute abdominal pain, nausea, and vomiting. Her evaluation included laboratory testing, abdominal radiography with contrast, and computed tomography (CT) of the abdomen and pelvis. Small bowel radiography with contrast demonstrated delayed transit. CT imaging revealed persistent small bowel distention with a transition point in the distal small bowel, suggestive of SBO. Given concern for mechanical obstruction and persistent symptoms without improvement, exploratory laparoscopy was performed with intraoperative gynecologic consultation. Adhesiolysis, left salpingectomy, and oophorectomy were completed. The patient was subsequently monitored postoperatively.
Results: Imaging revealed dilated small bowel loops with a transition point and delayed contrast transit, consistent with SBO. Laparoscopic evaluation demonstrated extensive small bowel dilation with a transition point in the left lower quadrant caused by an adhesive band originating from a markedly inflamed and edematous left fallopian tube. The adnexa appeared dark red with surrounding old blood and fungating inflammatory changes, raising concern for possible gynecologic malignancy. Adhesiolysis was performed, and due to gross adnexal pathology, a left salpingo-oophorectomy was completed following intraoperative OB-GYN consultation. Final pathology demonstrated acute salpingitis with congestion and inflammation, without evidence of malignancy.
Conclusion: Adhesive disease remains the leading cause of small bowel obstruction (SBO), with most cases related to prior abdominal surgery. Gynecologic pathology is a less commonly recognized source of adhesive obstruction. This case underscores the importance of considering gynecologic etiologies in the differential diagnosis of SBO in female patients, even decades after tubal ligation. Acute salpingitis can lead to inflammatory adhesive band formation resulting in bowel obstruction and may closely mimic malignancy intraoperatively. Awareness of gynecologic inflammatory sources of SBO can facilitate timely recognition, interdisciplinary management, appropriate surgical decision-making, and prevention of delays in definitive treatment.