Ancillary Procedures

• Abdominal x-ray• Abdominal CT scan• Barium enema(Upper GI and small bowel

series)

Abdominal x-ray • Indications:1. Look for a cause of pain or swelling in the belly or ongoing

nausea and vomiting. 2. Find a cause of pain in the lower back on either side of the

spine (flank pain). -show the size, shape, and position of the liver, spleen,

and kidneys 3. Look for stones in the gallbladder, kidneys, ureters, or bladder 4. Look for air outside of the bowel (intestines). 5. Find an object that has been swallowed or put into a body

cavity. 6. Confirm the proper position of tubes used by your doctor in

your treatment

Abdominal x-ray

• Ladder-like series of distended small-bowel loops – small -bowel obstruction but may also occur with obstruction of the right colon

• fluid levels in the bowel can be seen in upright views.

• same x ray findings and ‑symptoms occur in ileus (paralysis of the intestine without obstruction

Abdominal CT Scan

• abdominal CT rapidly creates detailed pictures of the structures abdomen

• Indications:1. Study blood vessels 2. Identify masses and

tumors, including cancer 3. Look for infections, kidney

stones, or appendicitisCT scan of the abdomen showing the intraluminal hypodense

filling defect with mottled appearance (arrow).

Abdominal CT Scan• partial small bowel obstruction.

– distended, fluid-filled loops of small bowel

– with air-fluid levels– hyperemia– bowel wall thickening

• note the discrepancy in caliber between dilated small bowel and decompressed small bowel and the stranding in the small bowel mesentery

• air in a decompressed descending colon is indicative of partial obstruction.

Abdominal CT Scan

• adhesive partial small bowel obstruction.– massively dilated small

intestine proximal to a thick adhesive band

– decompressed small bowel distal to the adhesion

Abdominal CT Scan

• early closed-loop small bowel obstruction– markedly edematous,

hyperemic small bowel• a finding indicative of

early strangulation

– air in the transverse colon and the descending colon (indicative of partial small bowel obstruction)

Barium enema

• massive sigmoid volvulus– tapered obstruction at

the rectosigmoid junction with a typical bird's-beak deformity

Barium enema

• Small bowel adhesions– due to previous surgery.

• Dilatation of proximal small bowel with adhesions and stenoses of distal small bowel

– Spiky contours of proximaly dilatated small bowel representing submucosal changes

– Mucosal tacking