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In small bowel obstruction, a mechanical or functional blockage prevents normal passage of intestinal contents leading to increased peristaltic effort in the dilated loops causing bowel loops proximal to the obstruction to dilate. Gas and fluid accumulates proximal to the obstruction. [2]
Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. [2] [5] Either the small bowel or large bowel may be affected. [1] Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas. [1]
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.
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 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. [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]
Frontal view of the abdomen with double bubble sign, patient was found to have duodenal atresia. In radiology, the double bubble sign is a feature of pediatric imaging seen on radiographs or prenatal ultrasound in which two air filled bubbles are seen in the abdomen, representing two discontiguous loops of bowel in a proximal, or 'high,' small bowel obstruction.