Differential Diagnosis for Bowel Obstruction in the Jejunum with No Previous Symptoms

• Single Most Likely Diagnosis
  • Intussusception: This is a condition where a part of the intestine telescopes into another part, often causing obstruction. It is a common cause of small bowel obstruction, especially in the jejunum, and can occur without previous symptoms.
• Other Likely Diagnoses
  • Adhesions: These are bands of fibrous tissue that can form between loops of intestine or between the intestine and other organs, leading to obstruction. They are a common cause of small bowel obstruction, especially in patients who have had previous abdominal surgery.
  • Hernias: Internal or external hernias can cause bowel obstruction by compressing or trapping a portion of the intestine. They can occur in the jejunum and may not have caused symptoms until the obstruction occurs.
  • Volvulus: This is a condition where the intestine twists around its mesentery, cutting off blood flow and causing obstruction. It can occur in the jejunum and may not have caused previous symptoms.
• Do Not Miss Diagnoses
  • Mesenteric ischemia: This is a condition where the blood flow to the intestine is compromised, leading to tissue death. It can cause bowel obstruction and is a medical emergency that requires prompt treatment.
  • Malignancy: Although less common, malignancies such as lymphoma or adenocarcinoma can cause bowel obstruction in the jejunum. Missing this diagnosis could have serious consequences.
  • Inflammatory bowel disease: Conditions such as Crohn's disease can cause bowel obstruction, although they often have preceding symptoms. However, in some cases, the obstruction may be the first presentation.
• Rare Diagnoses
  • Foreign body: Ingestion of a foreign body that becomes lodged in the jejunum can cause obstruction. This is more common in children or in adults with a history of eating disorders or other conditions that lead to ingestion of non-food items.
  • Gallstone ileus: This is a condition where a gallstone passes through a fistula into the intestine and becomes lodged, causing obstruction. It is a rare cause of bowel obstruction but can occur in the jejunum.
  • Congenital anomalies: Conditions such as intestinal malrotation or duplications can cause bowel obstruction in the jejunum, although these are typically diagnosed in childhood.