Large bowel obstruction

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Large bowel obstruction

  • The colon is gas-filled and dilated down to the level of the sigmoid colon.
  • The dilated colon is abruptly 'cut-off' at the level of obstruction (X).
  • The cause of obstruction in this patient was found to be a diverticular stricture.

Dilated small and large bowel

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Dilated small and large bowel

  • The entire large bowel is dilated down into the pelvis.
  • Dilated loops of small bowel are also visible. This indicates incompetence of the ileocaecal valve, which allows gas to build up in the small bowel as well as in the large bowel.
  • The obstruction was found to be due to an obstructing tumour of the sigmoid colon which was treated using a colonic stent (see image below).

Large bowel obstruction

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Large bowel obstruction

  • (Same patient as image above)
  • A colonic stent has been inserted and the colon is no longer dilated.
  • Colonic stents are placed in the emergency setting under radiological guidance. This allows patients to recover from the acute effects of obstruction before definitive surgery is performed.

Partial large bowel obstruction

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Partial large bowel obstruction

  • This image demonstrates dilatation of the colon down to an area where there is conspicuous narrowing of the bowel and an area of increased soft tissue density.
  • This was found to be a tumour of the descending colon.
  • Bowel obstruction can be complete or partial. Gas in the rectum, as seen in this case, is a feature of incomplete obstruction.
  • If bowel obstruction is seen on an abdominal X-ray then a CT is indicated to help plan treatment - see image below.

Partial large bowel obstruction - CT

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Partial large bowel obstruction - CT

  • (Same patient as image above)
  • The CT demonstrates narrowing of the descending colon due to a colonic soft tissue mass.