Presentation
Two days absolute constipation. Distended painful abdomen. Previous surgery.
Patient Data
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Multiple dilated small bowel loops in the central abdomen up to 3cm.
Collapsed large bowel.
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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 faeces sign in several pelvic loops.
Small volume of fluid in the pelvis.
Solid organs normal.
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A photograph of a grapevine snail.
Image credit: Geierunited
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.
Image attribution
Author: Geierunited
Original file: https://commons.wikimedia.org/wiki/File:Snail.jpg
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