Small bowel obstruction on lateral chest x-ray

Case contributed by Dr Henry Knipe

Presentation

Epigastric pain.

Patient Data

Age: 76
Gender: Male
Modality: X-ray

Cardiac silhouette is enlarged. Unfolded thoracic aorta. Lungs and pleural space are clear. No free subdiaphragmatic gas. Dilated loops of bowel with air fluid levels on the lateral projection, suggestive of obstruction. Thoracolumbar kyphosis secondary to mid/lower thoracic wedge compression fractures.

Case Discussion

Subsequent CT demonstrated a small bowel obstruction. The point of this case is that it is easy to overlook the corners of the film, and not interrogate the findings if you do seem them. The bowel loops are clearly dilated with numerous air-fluid levels. 

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Case Information

rID: 39616
Case created: 11th Sep 2015
Last edited: 11th Sep 2015
Inclusion in quiz mode: Included

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