Professional Documents
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Oleh :
Robin Permadi
1210070100176
Radiologic imaging has assumed a paramount role in
directing the management of small bowel obstruction,
promoted by the widespread availability of MDCT. The
key question for a clinician managing a case of
suspected small bowel obstruction is how to optimally
treat the patient.
Imaging Modalities
1. Radiography
bowel obstruction.
2. MDCT ( Multiple Detector Computed Tomography )
MDCT has been established as the modality of choice for imaging suspected
acute small bowel obstruction and is widely available.
The diagnosis of small bowel obstruction requires the presence of small bowel
dilatation (transverse diameter > 2.5 cm) and the presence of a discrete
transition zone between dilated proximal and nondilated distal bowel
Fig. 2—Small bowel obstruction
4. Enteroclysis
MR enterography is an
increasingly attractive option
for the assessment of small
bowel obstruction.
Therefore, it is most useful in
the setting of chronic small
bowel abnormality and
lowgrade obstruction. This is
particularly true in Crohn
disease, where reducing the
accumulated dose of ionizing
radiation in young patients is
desired.
Adhesions
Fig. 14—Gallstone ileus in elderly woman with small bowel obstruction due
to gallstone ileus.
A. Axial CT image of pelvis shows large laminated calculus within dilated
loop of distal ileum in midline (arrow).
B. Axial CT image through liver shows pneumobilia (arrows), consistent with
biliary-enteric fistula.
Intraluminal Obstruction