Zina Joan Ricci MD, Abstract Co-Author: Nothing to Disclose

Fernanda Samara Mazzariol MD, Presenter: Nothing to Disclose

Sarah Kyung Oh MD, Abstract Co-Author: Nothing to Disclose

Marjorie Werner Stein MD, Abstract Co-Author: Nothing to Disclose

Susan Judith Frank MD, Abstract Co-Author: Nothing to Disclose

Ellen Leslie Wolf MD, Abstract Co-Author: Nothing to Disclose

Shari Friedman MD, Abstract Co-Author: Nothing to Disclose

Malka B. Finkelstein MD, Abstract Co-Author: Nothing to Disclose

Milana Flusberg MD, Abstract Co-Author: Nothing to Disclose

Victoria Chernyak MD, Abstract Co-Author: Nothing to Disclose

Alla M. Rozenblit MD, Abstract Co-Author: Nothing to Disclose

1. A normal plain film does not always exclude SBO. 2. Plain films can be insensitive in the detection of SBO when the obstruction is in the proximal small bowel or the small bowel is fluid filled. If clinical suspicion exists, CT will be diagnostic. 3. Plain film is insensitive for the detection of strangulated obstruction and closed loop obstruction, both requiring CT for diagnosis. 4. The cause of SBO is generally not identified on plain film but easily determined on CT. 5. SBO may be erroneously diagnosed on plain film and CT can exclude obstruction and provide the correct diagnosis.

I. Causes of normal or nonspecific bowel gas pattern on plain film where the diagnosis of SBO is made on CT: 1. Proximal SBO with only a few dilated loops of bowel 2. Fluid filled loops in SBO 3. The vomiting patient with decompressed bowel 4. S/P NGT placement for SBO with decompressed bowel 5. Closed loop obstruction/internal hernia II. Causes of SBO pattern on plain film where CT shows absence of obstruction: 1. Acute mesenteric ischemia 2. Prior colectomy with secondary small bowel dilatation 3. Ileus 4. Scleroderma 5. Pseudoobstruction III. Cases of SBO of indeterminate cause on plain film where CT elucidates the etiology 1. Intussusception 2. Abdominal wall hernias 3. Neoplasm 4. Inflammatory enteritis

http://abstract.rsna.org/uploads/2014/14014402/14014402_v9rf.pdf

Ricci, Z, Mazzariol, F, Oh, S, Stein, M, Frank, S, Wolf, E, Friedman, S, Finkelstein, M, Flusberg, M, Chernyak, V, Rozenblit, A, Misleading Cases and Pitfalls in the Diagnosis of Small Bowel Obstruction on Plain Film with CT Correlation.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14014402.html