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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 ...
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 most common cause of non-duodenal intestinal atresia is a vascular accident in utero that leads to decreased intestinal perfusion and ischemia of the respective segment of bowel. [3] This leads to narrowing, or in the most severe cases, complete obliteration of the intestinal lumen .
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]
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 ]
The small intestine forms loops (B2) and slides back into the abdomen (B3) during resolution of the hernia. Meanwhile, the cecum moves from the left to the right side, which represents the additional 180° counterclockwise rotation of the intestine (C, central view). [4] The exact cause of intestinal malrotation is unknown.