Normal abdominal x-ray (large bowel gas)

Case contributed by Dr Jeremy Jones

Presentation

Severe lower abdominal pain and vomiting for 24 hours.

Patient Data

Age: 53
Gender: Female

Normal bowel gas pattern. Sterilisation clips noted in the pelvis. No abnormal calcification. Normal study.

Annotated image

The course of the large bowel is highlighted in this annotated stack of images. The caecum is the most inferior and lateral section of bowel on the right side of the abdomen and in this case is the starting point for the illustration.

The mottled appearance in the right upper quadrant is the appearance of faeces on a radiograph.

The appearance of the large bowel in this study is completely normal.

Case Discussion

This abdominal x-ray is normal. The large bowel is seen with faeces and gas throughout and there is no evidence of obstruction (it's not dilated). The small bowel is not seen.

A normal radiograph can help to rule out small bowel obstruction as a cause for pain and vomiting. However, it is not a very sensitive test and if clinical suspicion was high, a CT could be performed.

This patient's symptoms settled with pain relief and she was discharged without further investigations.

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Case information

rID: 34069
Case created: 3rd Feb 2015
Last edited: 9th Sep 2015
Inclusion in quiz mode: Excluded

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