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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.
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.
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]
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]
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]
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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]
Ascites (/ ə ˈ s aɪ t i z /; [5] Greek: ἀσκός, romanized: askos, meaning "bag" or "sac" [6]) is the abnormal build-up of fluid in the abdomen. [1] Technically, it is more than 25 ml of fluid in the peritoneal cavity, although volumes greater than one liter may occur. [4]