NMS. Casos Clínicos

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Chapter 8 ♦ Lower Gastrointestinal Disorders

Q: What abdominal radiograph is warranted? A: An obstructive series, which usually includes an upright posterior–anterior and lateral chest radiograph (CXR) and a flat and upright abdominal radiograph , is necessary. Q: How would you interpret this radiographic series (Figs. 8-1 and 8-2)? A: These radiographs, which are most typical of small bowel obstruction, show multiple air– fluid levels in the small bowel and no evidence of air in the colon or rectum. A computed tomography (CT) scan with contrast can also be obtained if the obstructive series is not adequate or the patient has a complex history, such as previous malignancy or radiation (Fig. 8-3).

There is no evidence of a complication such as perforation or necrosis of the bowel.

Figure 8-1: Plain radiograph of the supine abdomen showing bowel obstruction. (From McKenney MG, Mangonon PC, Moylan JA, eds. Understanding Surgical Disease: The Miami Manual of Surgery . Philadelphia: Lippincott-Raven; 1998:139.) SAMPLE