Intestinal Obstruction
Small Bowel Obstruction
Investigation of intestinal obstruction, whether it is small ver- sus large bowel or
mechanical versus functional, is a common indication for abdominal plain films. The
signs and symptoms of a small or large bowel obstruction depends on the location
and extent of the obstruction and can include nausea, vomit- ing, abdominal pain,
abdominal distention, and obstipation. Just as the clinical manifestations of the
obstruction depend on its location so do its radiographic findings. Duration of
symptoms, significant emesis, use of a nasogastric tube, and degree of obstruction
also contribute to the radiographic appearance of a bowel obstruction. With regard
to small bowel obstruction (SBO), the most common causes in descending order are
adhesions, Crohns disease, neoplasia, and hernia.5 Abdominal plain films have
been shown to be diagnostic in 50%66% of cases with approximately 20% falsenegative rate.4 The radiographic diagnosis of an SBO depends on the intraluminal
gas pattern projected upon the plain film. A nor- mal gas pattern is defined as small
amounts of gas distributed