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ui.case.use_touch_gestures
DICOM HelpSource: Local (us-east1-c)
Demographics:
55 years old, Female
Indication:
Abdominal pain
Findings
- Diffuse gaseous distension of the colon with relative paucity of bowel gas in the rectum
- Multiple surgical clips overlie the anatomic pelvis
- Midline abdominal surgical staples
- Wound VAC tubing overlies the left hemipelvis
Diagnosis
Large bowel obstruction
Sample Report
Diffuse gaseous distension of the colon with a relative paucity of bowel gas in the rectum. Findings could represent ileus in this postoperative patient, but developing large bowel obstruction is not excluded. Recommend attention on serial radiographs and consideration of CT for further evaluation if the patient's clinical status does not improve.
Discussion
- Large bowel obstruction is much less common than small bowel obstruction and occurs most commonly in the elderly
- The most common cause of large bowel obstruction is malignancy, followed by volvulus
- Although radiographs can usually identify the dilated colonic segments, they do not often clearly differentiate between true obstruction and causes of pseudo-obstruction, such as ileus and Ogilvie syndrome. CT is usually the next step in evaluation if there is clinical concern
- In this case, the patient had a partial colonic obstruction related to colorectal anastomotic stricture