Small bowel feces sign

Case contributed by Erik Ranschaert
Diagnosis certain


Abdominal complaints. The urologist requested an abdominal CT to exclude urolithiasis.

Patient Data

Age: 45 years
Gender: Male

Feculent material is mingled with gas bubbles in the distal small bowel, resembling the appearance of stool in the colon on CT scans. 

Case Discussion

The small bowel feces sign is a useful adjunct to other more traditional signs of small bowel obstruction (SBO), particularly in patients with low-grade or intermittent obstruction. It is the result of delayed intestinal transit and is believed to be caused by incompletely digested food, bacterial overgrowth or increased water absorption of the distal small bowel contents. Many patients demonstrating this radiologic feature require hospitalization and even surgical intervention.

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