Presentation
Two days absolute constipation. Distended painful abdomen. Previous surgery.
Patient Data
Multiple dilated small bowel loops in the central abdomen up to 3cm.
Collapsed large bowel.
NG tube tip in a distended fluid filled stomach.
The small bowel is dilated and fluid filled down to a transition point in the proximal ileum to the right of the midline of the pelvis, at the site of a vascular whirl. Small bowel feces sign in several pelvic loops.
Small volume of fluid in the pelvis.
Solid organs normal.
Case Discussion
The plain radiograph sign showing the dilated small bowel has a mollusc like appearance.
I am not aware of a snail sign, but if there was one it should be this.