Radiologic management of small bowel obstruction: A practical approach

The value of diagnostic imaging in the assessment of small bowel obstruction lies in its ability to answer questions to improve the clinical management of patients. These questions include: Is the small bowel obstructed? What are the level, cause, and severity of obstruction? Is strangulation likely to be present? Should treatment be operative or nonoperative? In this article, the different methods of contrast examination of the small bowel are reviewed, and recommendations to facilitate selection and performance of barium studies for small bowel obstruction are given. The indications for enteroclysis and computed tomography are discussed. A practical plain film-based approach to the diagnosis and management of small bowel obstruction is presented. Radiology assumes considerable importance and responsibility since it is able to supply relevant answers to many of the questions concerning small bowel obstruction.