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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.
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 ...
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 ...
Bowel ischemia: Computed tomography (CT) showing dilated loops of small bowel with thickened walls (black arrow), findings characteristic of ischemic bowel due to thrombosis of the superior mesenteric vein. Specialty: General surgery, vascular surgery, gastroenterology: Symptoms: Acute: sudden severe pain [1]
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.
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 small bowel follow-through may be characterized by delayed transit, distension near small bowel adhesions, and a "cauliflower" appearance due to peritoneal sclerosis-encapsulated bowel loop compression. Dilated loops of bowel may appear encased in a dense fibrous membrane or matted together and tethered posteriorly on ultrasonography. [48]
X-ray showing distended stomach and bowel loops. Dilated bowel loops are a characteristic of chronic intestinal pseudo-obstruction. Specialty: Gastroenterology: Symptoms: Abdominal pain, bloating, and distension. [1] Duration: Chronic. [1] Causes: Neurologic, paraneoplastic, autoimmune, metabolic/endocrine, genetic, or infectious diseases. [1 ...