A 55-year-old female presents with a high-pitched mechanical small bowel obstruction 5 years after an uncomplicated open hysterectomy. Abdominal imaging shows transition point with dilated proximal loops. What is the most common etiology of small bowel obstruction in patients with prior abdominal surgery?

Answer and explanation

Correct answer: A. Post-operative intra-abdominal adhesions

  1. Step 1: Post-operative peritoneal adhesions account for approximately 65% to 75% of all mechanical small bowel obstructions in developed nations.
  2. Step 2: Previous pelvic and abdominal surgeries create fibrous bands between loops of intestine or the abdominal wall.
Answer
Post-operative intra-abdominal adhesions.
Why not the others: 'Incarcerated femoral hernia' is the leading cause of SBO in patients without prior surgical history; 'Colorectal adenocarcinoma' causes large bowel obstruction rather than small bowel obstruction; 'Intussusception' is common in children and rare in adults (usually triggered by a lead point tumor).

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