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Plain Radiography, upright or lateral decubitus views: Multiple air-fluid levels in dilated small bowel loops and step-like arrangement of loops descending toward the pelvis. [3] Computed Tomography (CT): Clearly delineates dilated loops arranged in a stepwise pattern. CT can also be used to identify the transition point (site of obstruction ...
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.
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]
The opposed walls of adjacent bowel loops form the central cleft while the two sides of the bean represent gas‐filled segments of dilated bowel that form an inverted U‐shape. [2] Air-fluid levels may also be seen in the segments of dilated bowel.
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]
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]
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 ]