Small bowel obstruction

Case contributed by Dr Ian Bickle

Presentation

Previous laparotomy and incisional hernia repair. Distended abdomen and vomiting.

Patient Data

Age: 60 years
Gender: Female
X-ray

Artifact over the right lower quadrant in keeping with mesh hernia repair.

Multiple dilated gas filled loops of small bowel througout the abdomen.

The valvulae conniventes are beautifully illustrated indicated it is small bowel.

Case Discussion

The plain radiograph appearances are classical for a distal small bowel obstruction:

a.  Dilated small bowel

b.  The location is central within the abdomen

c.  Large bowel at the periphery is collapsed

d. The valvulae conniventes can be identified across the full width of the dilated loops confirming it to be small (not large) bowel.

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