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Bowel obstruction, also known as intestinal obstruction, is a mechanical or functional obstruction of the intestines which prevents the normal movement of the products of digestion. Either the small bowel or large bowel may be affected. Signs and symptoms include abdominal pain, vomiting, bloating and not passing gas. Mechanical obstruction is the cause of about 5 to 15% of cases of severe abdominal pain of sudden onset requiring admission to hospital.
A lower gastrointestinal series is a medical procedure used to examine and diagnose problems with the human colon of the large intestine. Radiographs are taken while barium sulfate, a radiocontrast agent, fills the colon via an enema through the rectum.
An upper gastrointestinal series, also called a barium swallow, barium study, or barium meal, is a series of radiographs used to examine the gastrointestinal tract for abnormalities. A contrast medium, usually a radiocontrast agent such as barium sulfate mixed with water, is ingested or instilled into the gastrointestinal tract, and X-rays are used to create radiographs of the regions of interest. The barium enhances the visibility of the relevant parts of the gastrointestinal tract by coating the inside wall of the tract and appearing white on the film. This in combination with other plain radiographs allows for the imaging of parts of the upper gastrointestinal tract such as the pharynx, larynx, esophagus, stomach, and small intestine such that the inside wall lining, size, shape, contour, and patency are visible to the examiner. With fluoroscopy, it is also possible to visualize the functional movement of examined organs such as swallowing, peristalsis, or sphincter closure. Depending on the organs to be examined, barium radiographs can be classified into "barium swallow", "barium meal", "barium follow-through", and "enteroclysis". To further enhance the quality of images, air or gas is sometimes introduced into the gastrointestinal tract in addition to barium, and this procedure is called double-contrast imaging. In this case the gas is referred to as the negative contrast medium. Traditionally the images produced with barium contrast are made with plain-film radiography, but computed tomography is also used in combination with barium contrast, in which case the procedure is called "CT enterography".
A chest radiograph, chest X-ray (CXR), or chest film is a projection radiograph of the chest used to diagnose conditions affecting the chest, its contents, and nearby structures. Chest radiographs are the most common film taken in medicine.
A volvulus is when a loop of intestine twists around itself and the mesentery that supports it, resulting in a bowel obstruction. Symptoms include abdominal pain, abdominal bloating, vomiting, constipation, and bloody stool. Onset of symptoms may be rapid or more gradual. The mesentery may become so tightly twisted that blood flow to part of the intestine is cut off, resulting in ischemic bowel. In this situation there may be fever or significant pain when the abdomen is touched.
Organomegaly is the abnormal enlargement of organs. For example, cardiomegaly is enlargement of the heart. Visceromegaly is the enlargement of abdominal organs. Examples of visceromegaly are enlarged liver (hepatomegaly), spleen (splenomegaly), stomach, kidneys, and pancreas.
Annular pancreas is a rare condition in which the second part of the duodenum is surrounded by a ring of pancreatic tissue continuous with the head of the pancreas. This portion of the pancreas can constrict the duodenum and block or impair the flow of food to the rest of the intestines. It is estimated to occur in 1 out of 12,000 to 15,000 newborns. The ambiguity arises from the fact that not all cases are symptomatic.
Pneumoperitoneum is pneumatosis in the peritoneal cavity, a potential space within the abdominal cavity. The most common cause is a perforated abdominal organ, generally from a perforated peptic ulcer, although any part of the bowel may perforate from a benign ulcer, tumor or abdominal trauma. A perforated appendix seldom causes a pneumoperitoneum.
Sialography is the radiographic examination of the salivary glands. It usually involves the injection of a small amount of contrast medium into the salivary duct of a single gland, followed by routine X-ray projections.
Distal intestinal obstruction syndrome (DIOS) involves obstruction of the distal part of the small intestines by thickened intestinal content and occurs in about 20% of mainly adult individuals with cystic fibrosis. DIOS was previously known as meconium ileus equivalent, a name which highlights its similarity to the intestinal obstruction seen in newborn infants with cystic fibrosis. DIOS tends to occur in older individuals with pancreatic insufficiency. Individuals with DIOS may be predisposed to bowel obstruction, though it is a separate entity than true constipation.
Pneumatosis intestinalis is pneumatosis of an intestine, that is, gas cysts in the bowel wall. As a radiological sign it is highly suggestive for necrotizing enterocolitis. This is in contrast to gas in the intestinal lumen. In newborns, pneumatosis intestinalis is considered diagnostic for necrotizing enterocolitis, and the gas is produced by bacteria in the bowel wall. The pathogenesis of pneumatosis intestinalis is poorly understood and is likely multifactorial. PI itself is not a disease, but rather a clinical sign. In some cases, PI is an incidental finding, whereas in others, it portends a life-threatening intra-abdominal condition.
Intestinal ischemia is a medical condition in which injury to the large or small intestine occurs due to not enough blood supply. It can come on suddenly, known as acute intestinal ischemia, or gradually, known as chronic intestinal ischemia. The acute form of the disease often presents with sudden severe abdominal pain and is associated with a high risk of death. The chronic form typically presents more gradually with abdominal pain after eating, unintentional weight loss, vomiting, and fear of eating.
Projectional radiography, also known as conventional radiography, is a form of radiography and medical imaging that produces two-dimensional images by X-ray radiation. The image acquisition is generally performed by radiographers, and the images are often examined by radiologists. Both the procedure and any resultant images are often simply called 'X-ray'. Plain radiography or roentgenography generally refers to projectional radiography. Plain radiography can also refer to radiography without a radiocontrast agent or radiography that generates single static images, as contrasted to fluoroscopy, which are technically also projectional.
An abdominal x-ray is an x-ray of the abdomen. It is sometimes abbreviated to AXR, or KUB.
An ileosigmoid knot or compound volvulus is an uncommon cause of intestinal blockage. The condition arises when ileum loops wrap around the bottom of a redundant sigmoid loop. In some countries in Africa, Asia, and the Middle East, the ileosigmoid knot is a well-known ailment; this condition is uncommon in the West.
Neonatal bowel obstruction (NBO) or neonatal intestinal obstruction is the most common surgical emergency in the neonatal period. It may occur due to a variety of conditions and has an excellent outcome based on timely diagnosis and appropriate intervention.
The colon cut-off sign is a radiographic finding seen on abdominal radiographs and computed tomography scans. It is characterized by a marked dilatation of the transverse colon, with an abrupt transition to collapsed distal colon, particularly the splenic flexure. This sign is indicative of underlying pathology, most commonly acute pancreatitis.
The kidney bean sign is a radiologic sign observed on abdominal radiographs that indicates the presence of a sigmoid volvulus, a form of bowel obstruction. It is seen as an area of hyperlucency resembling a coffee bean. The opposed walls of adjacent bowel loops form the central cleft while the two sides of the bean represent gas‐filled segments of dilated bowel that form an inverted U‐shape. Air-fluid levels may also be seen in the segments of dilated bowel.
The small bowel feces sign is a radiological finding observed in radiological imaging studies, particularly in cases of small bowel obstruction. It is characterized by the presence of particulate matter resembling fecal material within the lumen of dilated small bowel loops. This sign is most commonly identified on computed tomography (CT) scans and, less frequently, on abdominal radiographs.
The falciform ligament sign is a radiological sign observed on abdominal imaging in cases of pneumoperitoneum, where free intraperitoneal air outlines the falciform ligament. This sign is considered a diagnostic indicator of free air within the abdominal cavity and is most commonly identified on computed tomography (CT) scans and less frequently in abdominal radiographs.
References
- ↑ Hiatt, Kevin D.; Dyer, Raymond B. (1 March 2017). "The stepladder sign". Abdominal Radiology. 42 (3): 975–976. doi:10.1007/s00261-016-0933-2. ISSN 2366-0058. PMID 27714419 . Retrieved 3 January 2025.
- ↑ James, B; Kelly, B (September 2013). "The abdominal radiograph". The Ulster Medical Journal. 82 (3): 179–87. PMC 3913410 . PMID 24505155.
- ↑ Abhijit, Raut (2020). "Abdominal Radiograph" (PDF). Thieme Open Access. 3: S22 –S34. doi:10.1055/s-0040-1701327 . Retrieved 3 January 2025.