Common mechanical causes of small bowel obstruction include adhesions, hernia, Crohn disease and malignancy . Mechanical causes of large bow...
Common mechanical causes of small bowel obstruction include adhesions, hernia, Crohn disease and malignancy. Mechanical causes of large bowel obstruction are commonly malignancy, diverticulitis and volvulus. Non-mechanical causes include neuropathy, myopathy and systemic sclerosis.
PLAIN FILM
• Small bowel loops >3 cm in diameter, large bowel loops >6 cm and caecum >9 cm (‘3, 6, 9’).
• Check for pneumoperitoneum.
• Review the hernia orifices—is there an obstructing hernia?
CT
• Dilated loops before obstruction and collapsed loops after—look for a transition point (this may be easier to identify on coronal reformats).
• Closed loop obstruction may give a U- or C-shaped configuration to the dilated loops and stretched mesenteric vessels converging to a torsion point—the end result is gut ischaemia; check for pneumatosis.
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