Diagnostic Testing and Imaging

• Lab tests:
– Complete blood count
• Dehydration: BUN↑, Hb↑, Ht↑
• Intestinal bacteria translocate into bloodstream: Leuco ↑
– Metabolic panel
• Metabolic acidosis? Alkalosis (hiperemesis)?
– Serum lactate level ↑ (signal of bowel ischaemia)
• Radiography
– Abdominal rö:
supine: dilation of multiple loops
upright & LLD: air-fluid level in stepladder distribution
+lack of gas & stool in distal colon and rectum
• Computed Tomography
– ACR recommends CT as the initial imaging
modality for evaluation of intestinal obstruction.
– IV contrast CT of abdomen & pelvis
– Hasil: dilatasi proksimal, dekompresi distal
– Enterography (pada kasus low-grade/kronik,
jarang dilakukan)
• Contrast fluoroscopy: routine small-bowel follow-
through
*adanya kontras pada rectum dalam 24 jam adalah
indikator prognostik dari keberhasilan manajemen
nonoperatif dengan 97% sensitivitas resolusi spontan
dari obstruksi.
• Enteroclysis: nasoenteric intubation for rapid
delivery contrast media to distend entire small
bowel
• USG (85% sensitivity, inferior than CT)
• MRI