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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.
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]
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]
The treatment of intestinal ischemia depends on the cause and can be medical or surgical. However, if bowel has become necrotic, the only treatment is surgical removal of the dead segments of bowel. [34] In non-occlusive disease, where there is no blockage of the arteries supplying the bowel, the treatment is medical rather than surgical ...
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An acute appendicitis or twisted loop of the bowel may also be seen. If the picture is normal a functional cause such as irritable bowel syndrome (IBS) may be considered. In a healthy colon, barium should fill the colon uniformly and show normal bowel contour, patency (should be freely open), and position.