Plain film

Large bowel obstruction

Cause
• Neoplasm
• Inflammation eg. Diverticulitis
• Volvulus
• Hernia
• Anal stenosis

• Normal transverse colon diameter < 5.5 cm
• Dilatation of colon proximal to the obstruction
• Decreased gas distal to the obstruction
• Fluid level in the transverse or Lt.sided- colon
• cecum diameter > 9 cm: prone to perforation

• Gas-filled dilated
large bowel from
cecum to distal
descending colon

LBO แบ่งได้ 2 แบบ

• Type 1 : Competent ileocecal valve

– Type 1A : dilate colon and cecum, no small bowel
dilate

– Type 1B : Type 1A ทอ่ี ุดตนั นานๆ ทาให้ small bowel
dilate ได้

• Type 2 : Incompetent ileocecal valve

no cecum and ascending colon dilatation,
small bowel dilate

Large bowel volvulus

• Closed loop obstruction
• มักพบบริเวณ sigmoid colon, cecum, transverse

colon



• A large air-filled sigmoid loop arising from the
pelvis and extending cranially beyond the level
of the transverse colon

• Inverted U-shaped (Coffee bean sign)
• Closed loop

Gastric outlet obstruction

• Causes : peptic ulcer
carcinoma



• Dilatation of stomach
• Decreased distal bowel gas
• Displaced transverse colon
• Mottling appearance of foods

The End
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