Small bowel obstruction on AXR

Case contributed by Craig Hacking
Diagnosis certain

Presentation

Abdominal pain and distension.

Patient Data

Age: 40 years
Gender: Male
x-ray

Multiple loops of dilated small bowel in the central abdomen, with numerous airi-fluid levels of the erect projection (string of beads sign). No large bowel dilation. The hernial orifices are clear.No evidence of free gas or pneumotosis.

Case Discussion

Classic example of the radiographic features of SBO. 

The patient had a laparoscopy which confirmed adhesions as the cause of SBO, presumably from previous appendectomy.

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