What are the sites of bowel obstruction?

Small bowel
Large bowel

What is ileus?

Dilated bowel which may be from:

Paralytic
Obstructive

What are the common causes of ileus?

Paralytic ileus occurs when there is inflammation in the peritoneum,

most often following abdominal surgery; or other inflammations, like
appendicitis, pancreatitis, etc.
Normal postoperative ileus lasts 48 hours.
The absence of bowel sounds, flatus, or bowel movements beyond
the expected period indicates delayed resolution, or obstructed ileus.

What are the common causes of small bowel obstruction?

Post-op adhesions
Gallstone ileus
Intussusseption
Tumors

What are the common causes of large bowel obstruction?

Cancer colon
Fecal impaction
Diverticulitis

What are the anticipated imaging findings of bowel obstruction?

Dilated loops of bowel

Air fluid levels in the small bowel loops.

How do you distinguish small from large bowel?

Small bowel is in central abdomen

Large bowel is in the periphery of abdomen
Valvulae Connieventes crosses the entire width of small bowel
Haustra are seen partially across the width of large bowel
Bubbly appearance of feces indicates large bowel

Diverticula are present only in large bowel

Normal Bowel

Large bowel is identified by the sacculations calle

all along the colon.
The colon has fat filled tags called appendices epi
surface.
These haustra and epiploicae separate the large f
intestine.
Colon is filled with feces which has bubbly appear

The small bowel is located in the center of abdom

Fairly narrow about 2.5 cm tube like structure wind
and forth within the abdominal cavity
The small intestine is identified by valvulae circula
on oral contrast study.

Plain film in a case with Small bowel obstruction

Multiple dilated small bowel loops are seen (white arrow

There is fecal material in the right and left colon
(arrows).
Air is seen in the rectum.
The surgical staples indicate recent abdominal surgery.
arrowheads).

Small bowel obstruction

Cross lateral view shows multiple dilated fluid filled
loops of bowel with air fluid levels.

CT scan of another patient

findings of small bowel ob

A: Post op changes in
Arrowheads: Normal
bowel and Recto sigm
B: Arrowheads: Dilate
loops. Arrow: Area of

Gall stone Ileus

Air in Bile duct

Dilated small bowel
Gall stone is not seen
may overlie the sacru
dilated bowel seems t
arrow ]

Lower GI in a patient with Large bowel Obstru

Dilated bowel loops proximal to the obstru

Arrow points to the etiology of obstruction.