Bowels not open post op.
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Tenckhoff catheter projects over the pelvis. Left iliac fossa double J stent and surgical clips in keeping with renal transplant.
Prominent the non-dilated loops of small bowel with multiple non-specific air fluid levels. Gas is still present in the rectum. Features favor an ileus over a mechanical bowel obstruction.
Changes of avascular necrosis are noted in both femoral heads.
2 case question available
All the clues are here on the x-ray to:
- work out the cause of the patient's symptoms: paralytic ileus
- underlying cause: recent left iliac fossa renal transplant
- assess for complications: femoral head avascular necrosis (although this is not related to the current transplant but the underlying cause for renal failure / previous failed renal transplant; the cause in this patient is not known)