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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.
On CT imaging, the small bowel feces sign appears as a mottled, mixed-density pattern within a distended small bowel loop. It is typically located proximal to the site of obstruction and is often accompanied by other features of small bowel obstruction, such as: [5] Dilated bowel loops: Loops proximal to the obstruction exhibit dilation (>2.5-3 ...
On abdominal X-rays, the small intestine is considered to be abnormally dilated when the diameter exceeds 3 cm. [8] [9] On CT scans, a diameter of over 2.5 cm is considered abnormally dilated. [ 8 ] [ 10 ] The surface area of the human small intestinal mucosa , due to enlargement caused by folds, villi and microvilli, averages 30 square metres ...
CT Scans: More sensitive and specific than abdominal radiograph, revealing the extent of colonic dilatation, the transition point, and often associated peripancreatic inflammation or fluid collections. The colon cut-off sign is different from sentinel loop sign, where the dilated segment is a part of the small intestine.
In children, abdominal x-ray is indicated in the acute setting: Suspected bowel obstruction or gastrointestinal perforation; Abdominal x-ray will demonstrate most cases of bowel obstruction, by showing dilated bowel loops. [1] Foreign body in the alimentary tract; can be identified if it is radiodense. [1] Suspected abdominal mass [1]
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]
Depending on the level of obstruction, bowel obstruction can present with abdominal pain, abdominal distension, and constipation.Bowel obstruction may be complicated by dehydration and electrolyte abnormalities due to vomiting; respiratory compromise from pressure on the diaphragm by a distended abdomen, or aspiration of vomitus; bowel ischemia or perforation from prolonged distension or ...
The treatment of intestinal ischemia depends on the cause and can be medical or surgical. However, if bowel has become necrotic, the only treatment is surgical removal of the dead segments of bowel. [34] In non-occlusive disease, where there is no blockage of the arteries supplying the bowel, the treatment is medical rather than surgical ...