CT
Axial C+ portal venous phase
Coronal C+ portal venous phase
Is this a mechanical obstruction or pseudo-obstruction?
Mechanical large bowel obstruction - there is a "apple-core" stricture in the sigmoid colon with proximal colonic dilatation and distal colonic collapse.
Are small or large bowel obstructions more common?
Small bowel obstructions are the most common. They account for ~80% of all intestinal obstructions.
There is marked dilation of the stomach, small bowel and large bowel with air-fluid levels. The transition point is at the rectosigmoid junction, where there is a shouldered apple core stenosing lesion.
There is a small volume of free fluid in the pelvis. No mural or portal venous gas.
Bilateral inguinal hernias contain fat and free fluid on the left, and fat and the anti-mesenteric border of a short segment of sigmoid colon on the right. Moderate hiatus hernia. Right adrenal nodule.