Radiology – Case 2

The Xray given above was taken in a 37 year old patient who presented with acute colicky abdominal pain. Spot the diagnosis! How many air fluid levels are normally seen? Which are the normal sites where air fluid levels are seen?

The X-ray shows multiple air fluid levels. This finding combined with the history of colicky abdominal pain points towards the diagnosis of acute obstruction of small bowel. The obstruction may be due to adhesion, hernia, neoplasm, foreign body etc. Studies have shown that a normal person has on average 4 air fluid levels. Most of them are seen in the colon.  For the diagnosis of small intestinal obstruction, we should see more than 2 air fluid levels among the dilated loops of small bowel.

Image credits: James Heilman, MD (Wikipedia)

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