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Small Bowel Obstruction
Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Small bowel obstruction (SBO)
            • Definitions

              • Obstruction or blockage of ≥ 1 SB segments by intrinsic or extrinsic narrowing of SB lumen

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic Findings

                  • CT Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Geffroy Y et al: Increased unenhanced bowel-wall attenuation at multidetector CT is highly specific of ischemia complicating small-bowel obstruction. Radiology. 270(1):159-67, 2014
                                          2. Keenan JE et al: Trials of nonoperative management exceeding 3 days are associated with increased morbidity in patients undergoing surgery for uncomplicated adhesive small bowel obstruction. J Trauma Acute Care Surg. 76(6):1367-72, 2014
                                          3. Millet I et al: Adhesive small-bowel obstruction: value of CT in identifying findings associated with the effectiveness of nonsurgical treatment. Radiology. 273(2):425-32, 2014
                                          4. O'Leary EA et al: Letting the sun set on small bowel obstruction: can a simple risk score tell us when nonoperative care is inappropriate? Am Surg. 80(6):572-9, 2014
                                          5. Suri RR et al: Computed tomography features associated with operative management for nonstrangulating small bowel obstruction. Can J Surg. 57(4):254-9, 2014
                                          6. Barnett RE et al: Accuracy of computed tomography in small bowel obstruction. Am Surg. 79(6):641-3, 2013
                                          7. Lai CC et al: Usefulness of CT for differentiating between obturator hernia and other causes of small bowel obstruction. Postgrad Med J. 89(1058):729-30, 2013
                                          8. van Oudheusden TR et al: Challenges in diagnosing adhesive small bowel obstruction. World J Gastroenterol. 19(43):7489-93, 2013
                                          9. Delabrousse E et al: Small-bowel obstruction from adhesive bands and matted adhesions: CT differentiation. AJR Am J Roentgenol. 192(3):693-7, 2009
                                          10. Jancelewicz T et al: Predicting strangulated small bowel obstruction: an old problem revisited. J Gastrointest Surg. 13(1):93-9, 2009
                                          11. Lee IK et al: Selective laparoscopic management of adhesive small bowel obstruction using CT guidance. Am Surg. 75(3):227-31, 2009
                                          12. Silva AC et al: Small bowel obstruction: what to look for. Radiographics. 29(2):423-39, 2009
                                          13. Delabrousse E et al: Small-bowel bezoar versus small-bowel feces: CT evaluation. AJR Am J Roentgenol. 191(5):1465-8, 2008
                                          14. Duda JB et al: Utility of CT whirl sign in guiding management of small-bowel obstruction. AJR Am J Roentgenol. 191(3):743-7, 2008
                                          15. Mak SY et al: Small bowel obstruction: computed tomography features and pitfalls. Curr Probl Diagn Radiol. 35(2):65-74, 2006
                                          16. Fazel A et al: New solutions to an old problem: acute colonic pseudo-obstruction. J Clin Gastroenterol. 39(1):17-20, 2005
                                          17. Lazarus DE et al: Frequency and relevance of the "small-bowel feces" sign on CT in patients with small-bowel obstruction. AJR Am J Roentgenol. 183(5):1361-6, 2004
                                          18. Khurana B et al: Bowel obstruction revealed by multidetector CT. AJR Am J Roentgenol. 178(5):1139-44, 2002
                                          19. Furukawa A et al: Helical CT in the diagnosis of small bowel obstruction. Radiographics. 21(2):341-55, 2001
                                          20. Maglinte DD et al: Small-bowel obstruction: optimizing radiologic investigation and nonsurgical management. Radiology. 218(1):39-46, 2001
                                          21. Caoili EM et al: CT of small-bowel obstruction: another perspective using multiplanar reformations. AJR Am J Roentgenol. 174(4):993-8, 2000
                                          22. Nevitt PC: The string of pearls sign. Radiology. 214(1):157-8, 2000
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Small bowel obstruction (SBO)
                                                    • Definitions

                                                      • Obstruction or blockage of ≥ 1 SB segments by intrinsic or extrinsic narrowing of SB lumen

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • Fluoroscopic Findings

                                                          • CT Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Geffroy Y et al: Increased unenhanced bowel-wall attenuation at multidetector CT is highly specific of ischemia complicating small-bowel obstruction. Radiology. 270(1):159-67, 2014
                                                                                  2. Keenan JE et al: Trials of nonoperative management exceeding 3 days are associated with increased morbidity in patients undergoing surgery for uncomplicated adhesive small bowel obstruction. J Trauma Acute Care Surg. 76(6):1367-72, 2014
                                                                                  3. Millet I et al: Adhesive small-bowel obstruction: value of CT in identifying findings associated with the effectiveness of nonsurgical treatment. Radiology. 273(2):425-32, 2014
                                                                                  4. O'Leary EA et al: Letting the sun set on small bowel obstruction: can a simple risk score tell us when nonoperative care is inappropriate? Am Surg. 80(6):572-9, 2014
                                                                                  5. Suri RR et al: Computed tomography features associated with operative management for nonstrangulating small bowel obstruction. Can J Surg. 57(4):254-9, 2014
                                                                                  6. Barnett RE et al: Accuracy of computed tomography in small bowel obstruction. Am Surg. 79(6):641-3, 2013
                                                                                  7. Lai CC et al: Usefulness of CT for differentiating between obturator hernia and other causes of small bowel obstruction. Postgrad Med J. 89(1058):729-30, 2013
                                                                                  8. van Oudheusden TR et al: Challenges in diagnosing adhesive small bowel obstruction. World J Gastroenterol. 19(43):7489-93, 2013
                                                                                  9. Delabrousse E et al: Small-bowel obstruction from adhesive bands and matted adhesions: CT differentiation. AJR Am J Roentgenol. 192(3):693-7, 2009
                                                                                  10. Jancelewicz T et al: Predicting strangulated small bowel obstruction: an old problem revisited. J Gastrointest Surg. 13(1):93-9, 2009
                                                                                  11. Lee IK et al: Selective laparoscopic management of adhesive small bowel obstruction using CT guidance. Am Surg. 75(3):227-31, 2009
                                                                                  12. Silva AC et al: Small bowel obstruction: what to look for. Radiographics. 29(2):423-39, 2009
                                                                                  13. Delabrousse E et al: Small-bowel bezoar versus small-bowel feces: CT evaluation. AJR Am J Roentgenol. 191(5):1465-8, 2008
                                                                                  14. Duda JB et al: Utility of CT whirl sign in guiding management of small-bowel obstruction. AJR Am J Roentgenol. 191(3):743-7, 2008
                                                                                  15. Mak SY et al: Small bowel obstruction: computed tomography features and pitfalls. Curr Probl Diagn Radiol. 35(2):65-74, 2006
                                                                                  16. Fazel A et al: New solutions to an old problem: acute colonic pseudo-obstruction. J Clin Gastroenterol. 39(1):17-20, 2005
                                                                                  17. Lazarus DE et al: Frequency and relevance of the "small-bowel feces" sign on CT in patients with small-bowel obstruction. AJR Am J Roentgenol. 183(5):1361-6, 2004
                                                                                  18. Khurana B et al: Bowel obstruction revealed by multidetector CT. AJR Am J Roentgenol. 178(5):1139-44, 2002
                                                                                  19. Furukawa A et al: Helical CT in the diagnosis of small bowel obstruction. Radiographics. 21(2):341-55, 2001
                                                                                  20. Maglinte DD et al: Small-bowel obstruction: optimizing radiologic investigation and nonsurgical management. Radiology. 218(1):39-46, 2001
                                                                                  21. Caoili EM et al: CT of small-bowel obstruction: another perspective using multiplanar reformations. AJR Am J Roentgenol. 174(4):993-8, 2000
                                                                                  22. Nevitt PC: The string of pearls sign. Radiology. 214(1):157-8, 2000