Abdominal Radiography Findings in Small-Bowel Obstruction
Relevance to Triage for Additional Diagnostic Imaging
John C. Lappas1,
Benedicto L. Reyes2 and
Dean D. T. Maglinte3
1
Department of Radiology, Indiana University School of Medicine, Wishard
Memorial Hospital, 1001 W. Tenth St., Indianapolis, IN 46202.
2
Department of Radiology, St. Francis Hospital, 1500 Albany St., Beech Grove,
IN 46107.
3
Department of Radiology, Indiana University School of Medicine, 550 N.
University Blvd., Indianapolis, IN 46202.
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Fig. 1A. —Grades of small-bowel obstruction. Low-grade partial
obstruction in 70-year-old man. Enteroclysis shows contrast medium in dilated
small-bowel loop flowing (curved arrow) into discrete transition
zone, represented by compressed lumen segment (straight arrow).
Contrast medium enters distal (D) bowel at rate of flow sufficient to achieve
moderate lumen distension and to reveal mucosal folds.
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Fig. 1B. —Grades of small-bowel obstruction. High-grade partial
obstruction in 72-year-old woman. Enteroclysis shows contrast medium in
dilated small-bowel loop flowing (curved arrow) into severely
compressed lumen segment (straight arrows). Rate of flow is impeded
to degree that small amounts of contrast medium enter collapsed distal (D)
bowel loops that have no defined mucosal folds.
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Fig. 1C. —Grades of small-bowel obstruction. Complete obstruction in
84-year-old man. Enteroclysis shows that contrast medium fails to flow
(curved arrow) through completely compressed lumen segment
(straight arrow), and bowel loops distal to obstruction are not
visualized.
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Fig. 2. —Abdominal radiograph with patient supine in 27-year-old woman
with high-grade partial small-bowel obstruction shows method of bowel lumen
diameter measurement. Small-bowel loops (dotted lines) and colon
segments (solid lines) were measured from widest bowel margin
transverse to long axis of bowel. Left lower quadrant small-bowel loop
measures 32 mm in diameter, and segment of transverse colon measures 40 mm in
diameter.
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Fig. 3. —Abdominal radiograph with patient supine in 34-year-old man
with complete small-bowel obstruction. Stretch sign is depicted by abnormal
distention of predominantly fluid-filled small-bowel loop where luminal gas
has striped appearance oriented perpendicular to long axis of bowel
(arrows).
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Fig. 4. —Abdominal radiograph with patient upright in 36-year-old
woman with high-grade partial small-bowel obstruction. Small-bowel loops A and
B show differential height of air-fluid levels (dotted lines) and
were measured as vertical height (solid arrows) between corresponding
air-fluid levels in same bowel loop. Differential air-fluid height measures 31
mm in loop A and 5 mm in loop B. String-of-beads sign is depicted by air-fluid
levels measuring less than 10 mm in diameter (open arrow).
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Copyright © 2001 by the American Roentgen Ray Society.
