| Summary: | Although intestinal obstruction is a relatively common condition to be seen in daily clinical practice, cases with no history of laparotomy can often create difficulties in determining its diagnosis and surgical indication. This is a case report of a recurrent intestinal obstruction, with no surgical history, treated successfully using laparoscopy for both diagnosis and surgical operation.The patient, 62-year-old male, was hospitalized about a year ago due to abdominal pain and diarrhea likely caused by acute enteritis. As the inflammation had reduced and X-Ray image no longer indicated any gas patterns in the small intestine, he was later discharged from the hospital. However, the symptoms recurred after seven months which included abdominal pain, diarrhea as well as bloating. The patient was then introduced to our hospital through a local clinic for further diagnosis.The results resembled patient's previous hospitalization observing a formation of niveau, or mirror-image, in the upper abdomen as well as a sentinel loop with some swelling on computed tomography (CT) image. With conservative treatment, the patient showed rather a quick recovery soon after his admission. The inflammation and the intestinal obstruction had reduced. However, as recurrence had appeared in a similar area as his previous experience, the patient underwent diagnostic laparoscopy for further inspection of its underlying cause.Adhesion of the ileum and the sigmoid colon was observed. After diagnosis, laparoscopic adhesiolysis was performed in order to divide the adhesion and to remove the inflated part of the small intestine. The postoperative course was positive and the patient was discharged from the hospital 13 days after the surgery. There has been no report of recurrence thereafter.Technological development of CT scanners in recent years has enabled new levels of information. However, cases with no surgical history and fluctuating symptoms, such as the patient mentioned in this paper, requires direct observation of the tract. Doing so also helps determine the possibility of an internal hernia. Furthermore, laparoscopy enables a smooth shift from diagnosis to treatment, with the assistance of laparoscope, which avoids unnecessary invasion and requires only small incisions; serving it as a very effective approach to certain cases of intestinal obstruction.
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