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Frequency and Relevance of the "Small-Bowel Feces" Sign on CT in Patients with Small-Bowel Obstruction

¹ All authors: Department of Radiology, Section of Abdominal Imaging, New York University Medical Center, Tisch Hospital, 560 First Ave., Ste. HW 207, New York, NY 10016.

View larger version (136K): [in a new window]   Fig. 1A. —Small-bowel obstruction due to adhesion in 54-year-old woman (patient 4 in Table 1). Axial CT scan obtained with IV and oral contrast material at level of upper pelvis shows dilated loops of small bowel that are filled with contrast material (arrow).

View larger version (148K): [in a new window]   Fig. 1B. —Small-bowel obstruction due to adhesion in 54-year-old woman (patient 4 in Table 1). Axial CT scan obtained 5 cm caudad to A shows "small-bowel feces" sign (SBFS) (arrow) at point of transition.

View larger version (104K): [in a new window]   Fig. 1C. —Small-bowel obstruction due to adhesion in 54-year-old woman (patient 4 in Table 1). Coronal reformatted image shows dilated loop (arrow) of small bowel filled with fluid.

View larger version (89K): [in a new window]   Fig. 1D. —Small-bowel obstruction due to adhesion in 54-year-old woman (patient 4 in Table 1). Coronal reformatted image obtained several centimeters ventral to C shows intraluminal SBFS (arrow) at point of transition. Patient had remote history of prior surgery and improved with nasogastric tube decompression. Cause of obstruction was believed to be adhesion.

View larger version (121K): [in a new window]   Fig. 2A. —Small-bowel obstruction due to adhesion in 80-year-old woman (patient 7 in Table 1). Axial CT scan obtained with IV and oral contrast material at level of upper pelvis shows markedly dilated loop (arrow) of small bowel filled with fluid.

View larger version (125K): [in a new window]   Fig. 2B. —Small-bowel obstruction due to adhesion in 80-year-old woman (patient 7 in Table 1). Axial CT scan obtained 5 cm cephalad to A shows intraluminal "small-bowel feces" sign (SBFS) (arrow).

View larger version (116K): [in a new window]   Fig. 2C. —Small-bowel obstruction due to adhesion in 80-year-old woman (patient 7 in Table 1). Coronal reformatted image shows dilated loop of small bowel filled with fluid at transition zone (arrow). SBFS is seen within lumen of small bowel. Note totally collapsed loops of distal small bowel (arrowhead). Patient had history of prior surgery and improved with nasogastric tube decompression. Cause of obstruction was believed to be adhesion.

View larger version (142K): [in a new window]   Fig. 3A. —Small-bowel obstruction due to hernia in 70-year-old man (patient 20 in Table 1). Axial CT scan obtained with IV and oral contrast material at level of kidneys shows dilated loop (arrow) of small bowel entering ventral hernia. No "small-bowel feces" sign is present.

View larger version (146K): [in a new window]   Fig. 3B. —Small-bowel obstruction due to hernia in 70-year-old man (patient 20 in Table 1). Axial CT scan obtained 2 cm cephalad to A shows exiting collapsed loop (arrow).

View larger version (164K): [in a new window]   Fig. 4A. —Small-bowel obstruction due to gallstone in 70-year-old man (patient 22 in Table 1). Axial CT scan obtained with IV and oral contrast material at level of kidneys shows dilated loop (arrow) of small bowel. Note pneumobilia (arrowhead).

View larger version (164K): [in a new window]   Fig. 4B. —Small-bowel obstruction due to gallstone in 70-year-old man (patient 22 in Table 1). Axial CT scan obtained in mid pelvis show partially obstructing gallstone (arrowhead). No "small-bowel feces" sign is seen in bowel loop (arrow) proximal to gallstone.

View larger version (128K): [in a new window]   Fig. 5. —Small-bowel obstruction due to adhesion in 58-year-old man (patient 26 in Table 1). Coronal reformatted image shows progressive increase in density of particulatelike material ("small-bowel feces" sign) within obstructed small-bowel loop up to point of transition (arrow). In more proximal small bowel, intraluminal content is fluid (arrowhead).

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