Bowel obstruction other diagnostic studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Overview

Other diagnostic studies for bowel obstruction include contrast studies, which demonstrate dilated proximal bowel loops, point of transition, and complete obstruction. Contrast enema is useful in those who have had a previous surgical reconstruction of the bowel. Enteroclysis is a useful study in those with chronic or recurrent bowel obstruction.

Other Diagnostic Studies

Contrast studies may be helpful in the diagnosis of bowel obstruction. Findings suggestive of bowel obstruction include:

• Proximal dilated bowel loop
• Distal obstruction
  • Usually void of contrast media if a complete obstruction
• Point of transition
  • Can indicate the position of blockage and distinguish between proximal and distal segment of the bowel

Limitations of contrast studies

• Etiology cannot be determined
• Contraindicated in strangulated bowel loops
• May miss transition point as contrast may become diluted and therefore, visualization of bowel may be lost
• Cannot identify closed loop obstruction or ischemia

Further studies

• Other diagnostic studies for bowel obstruction include:
  • Contrast enema, which is useful in the presence of:
    • Proctocolectomy with an ileoanal J-pouch
    • Subtotal colectomy and ileorectal anastomosis
      • Water-based contrast is preferred over barium
  • Enteroclysis introduces both air and media (methylcellulose) into the bowel, and demonstrates:
    • Stenosis of the bowel
    • Prolonged bowel transit time

References

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