Adhesional small bowel obstruction

Case contributed by Ian Bickle
Diagnosis certain

Presentation

Two days absolute constipation. Distended painful abdomen. Previous surgery.

Patient Data

Age: 80 years
Gender: Female

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.

The shell of a mollusc

Photo

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.

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.