What assessment findings are expected with a small bowel obstruction?
The patient with a small bowel obstruction will usually present with abdominal pain, abdominal distension, vomiting, and inability to pass flatus. In a proximal obstruction, nausea and vomiting are more prevalent.
What is an obstructive series?
When 2 or more of these views are taken, the set of films may be called an obstruction series. This series of X-rays is done to try to locate a site of a suspected blockage in the abdomen or intestine.
What are the typical views seen in an abdomen series?
The usual projections for this series are AP supine view (to estimate the amount of bowel gas or possible distension), PA erect view (to assess air-fluid levels), and PA erect chest radiograph (to rule out free air) .
What radiographic findings are typical of intestinal obstruction?
The key radiographic signs that allow distinction between a high-grade SBO and a low-grade obstruction are the presence of small bowel distention, with maximal dilated loops averaging 36 mm in diameter and exceeding 50% of the caliber of the largest visible colon loop as well as a 2.5 times increase in the number of …
How do you assess a patient with a bowel obstruction?
The doctor may suspect intestinal obstruction if your abdomen is swollen or tender or if there’s a lump in your abdomen. He or she may listen for bowel sounds with a stethoscope. X-ray. To confirm a diagnosis of intestinal obstruction, your doctor may recommend an abdominal X-ray.
What is included in an abdominal series?
The standard abdominal X-ray protocol is usually a single anteroposterior projection in supine position. Special projections include a PA prone, lateral decubitus, upright AP, and lateral cross-table (with the patient supine).
What is abdominal series?
The acute abdominal series is a common set of abdominal radiographs obtained to evaluate bowel gas.
What is a normal bowel gas pattern?
Normal bowel gas pattern Normal bowel gas has very variable appearance. In this example the wavy ‘ruggae’ of the stomach wall can be seen. A short segment of the colon is prominent, but is not frankly dilated. Faecal material is visible in the right hemi-colon.
How many air fluids is normal?
Air-fluid levels are common in normal bowel, but multiple ones (>3 air-fluid levels) usually indicate intestinal obstruction [2].
What are normal active bowel sounds?
Normoactive: 5–30 bowel sounds per minute (about 2 sounds every 5 seconds). Generally, you will only need to listen for a few seconds to estimate this frequency.
Are bowel loops normal?
The normal bowel wall is 3-5 mm thick, and normal loops of bowel are yielding and easily deformed during examination. The configuration of the loops may be altered as a result of peristalsis and distention with fluid and air.
What CT findings are characteristic of small bowel obstruction (SBO)?
Because this condition responds to medical treatment, it is important to recognize it. At CT, the findings consist of SBO with feculent filling defects in the small bowel (, Fig 24) (, 30,, 48 ).
How do you determine the level of bowel obstruction?
The level of the obstruction is determined by means of the location of the bowel loops and the pattern of the valvulae conniventes. As with other cross-sectional imaging techniques, the cause of the SBO may be determined by examining the area of transition from the dilated to normal bowel.
When is a complete obstruction considered to be present?
Therefore, a complete obstruction is considered to be present when there is no passage of contrast medium beyond the point of obstruction on delayed scans obtained at 3–24 hours (, Fig 5 ). Figure 5. Simple complete SBO secondary to intussusception.
Which radiographic findings predict the severity of abdominal obstruction?
The two radiographic findings considered of greatest significance as predictors of the severity of obstruction were findings seen only on the upright abdominal radiograph.