Non-tuberculosis intestinal obstruction – Think Endometriosis Case study and a review of the literature

Mrs X presented to casualty with a week history of abdominal distension, nausea and vomiting post prandially. The patient was HIV positive and her CD4 was 416. Abdominal ultrasound done on admission showed dilated lops of bowel with no other significant abnormality. Plain abdominal X-Ray revealed dilated loops of small bowel. The chest X-Ray showed small bilateral effusions. The patient was admitted and a NGT was inserted and intra venous fluids started. The patient was kept nil per mouth. The patient at this time had a distended abdomen which was in keeping with gaseous distension.