Michael S. Berry, MD


Appl Radiol. 2004;33(8) 

In This Article

Case Summary

A 55-year-old woman with a history of radiation enteritis and biliary colic, resulting in laparoscopic cholecystectomy 10 days prior to admission, presented to the emergency department (ED) after 7 days of progressive epigastric pain, abdominal distention, nausea, and vomiting. Physical examination revealed diffuse abdominal tenderness, which was greatest in the epigastric region and right upper quadrant, without palpable mass. Abdominal radiography showed a dilated loop of small bowel, scattered air-fluid levels, and decompressed colon (Figure 1). An emergent right upper quadrant ultrasound request from the ED was considered, but computed tomography (CT) scanning was recommended, as it would be able to assess the small-bowel obstruction and possible complications of recent cholecystectomy.

Abdominal radiograph taken on admission is suggestive of early or partial small-bowel obstruction.