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Radiological signs of bowel obstruction include bowel distension (small bowel loops dilated >3 cm) and the presence of multiple (more than 2) air-fluid levels on supine and erect abdominal radiographs. [16] Ultrasounds may be as useful as CT scanning to make the diagnosis. [17]
Dilated bowel loops: Loops proximal to the obstruction exhibit dilation (>2.5-3 cm in diameter). Transition zone: A point where the caliber of the bowel changes from dilated to collapsed, indicating the site of obstruction. Air-fluid levels: Seen in upright or decubitus imaging, reflecting stasis of luminal contents.
Ultrasound and computed tomography (CT) imaging of the abdomen can confirm the diagnosis by demonstrating dilated loops of intestine with material in the intestinal lumen with bubbles. [1] Air-fluid levels may be seen in those affected by DIOS. [1]
The stepladder sign is a radiological finding observed in the context of small bowel obstruction on abdominal X-rays or computed tomography scans. It refers to the appearance of multiple, dilated small bowel loops arranged in a step-like configuration, typically visible in upright or lateral decubitus imaging positions.
Volvulus causes severe pain and progressive injury to the intestinal wall, with accumulation of gas and fluid in the portion of the bowel obstructed. [11] Ultimately, this can result in necrosis of the affected intestinal wall, acidosis, and death. This is known as a closed-loop obstruction because there exists an isolated ("closed") loop of bowel.
One of the causes of abnormal bloating is excessive eating and air swallowing, known as aerophagia. [2] Other causes of bloating and distension include inflammatory bowel diseases such as Crohn's disease [3] [4] and ulcerative colitis, irritable bowel syndrome, diabetes, functional dyspepsia, or transient constipation.
Simple and cheap to perform, plain film x-rays can show the traditional indicator of air-fluid levels and dilated bowel loops, which is best seen in the erect film. [25] Abdominal x-rays , however, are unable to definitively differentiate between genuine mechanical intestinal obstruction and pseudo-obstruction . [ 26 ]
Chilaiditi syndrome is a rare condition when pain occurs due to transposition of a loop of large intestine (usually transverse colon) in between the diaphragm and the liver, visible on plain abdominal X-ray or chest X-ray. [1] Normally this causes no symptoms, and this is called Chilaiditi's sign. The sign can be permanently present, or ...