Small bowel obstruction (string of pearls sign)

Case contributed by Dr Maulik S Patel

Presentation

Vomiting - 2 - 3 days. P/H/O two laparotomies

Patient Data

Age: 65 yrs
Gender: Male
Modality: X-ray

Small bowel obstruction. Multiple air-fluid levels showing small bowel morphology. String of pearls sign present.

Modality: Ultrasound

Multiple ultrasound images demonstrating portal venous gas.

Case Discussion

Radiograph - Multiple air fluid levels of small bowel morphology. String of pearls sign favour fluid distended loop.

Ultrasound: Gas in the peripheral part of right lobe liver in portal venous branches.  Vascularity was present in dilated small bowel. A point of transition from dilated to collapsed loop was noted just below umbilicus. No mass could be localized here.

Surgery after 1 hr confirmed findings. Bowel was viable. An adhesion band was present at the point of transition, which was then released.

Small bowel obstruction

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Case Information

rID: 14006
Case created: 13th Jun 2011
Last edited: 23rd Oct 2016
Inclusion in quiz mode: Included

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