What is the role of radiography in distinguishing the different types of small-bowel obstructions (SBO)?

Updated: Apr 28, 2017
  • Author: Mityanand Ramnarine, MD, FACEP; Chief Editor: Steven C Dronen, MD, FAAEM  more...
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Answer

Plain radiography is of little assistance in differentiating strangulation from simple obstruction. Some have used abdominal radiography to distinguish between complete obstruction and partial or no SBO.

A study by Lappas et al proposed that 2 findings were more predictive of a higher grade or complete SBO: (1) the presence of an air-fluid differential height in the same small-bowel loop and (2) the presence of a mean level width greater than 25 mm. [12]  When the 2 findings were present, the obstruction was most likely high grade or complete. When both were absent, the authors proposed, a low-grade (partial) SBO was likely or nonexistent.


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