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316 NORTH CAROLINA MEDICAL JOURNAL A.pril, 1945 Intestinal Obstruction The roentgen diagnosis of this condition is based primarily on the demonstration of fluid levels in the gas-distended gut. These may be shown on a scout film of the abdomen made with the patient in the erect or lateral decubitus position. The immediate results of obstruction are the accumulation of intestinal contents proximal to the point of obstruction and emptying of the intestine distal to this point. Gas accumulates within a few hours, thus supplying the condition necessary for the formation of fluid levels. The chief roentgen findings in cases of acute intestinal obstruction are dilated, gas-filled loops of bowel showing fluid levels. Because of increased peristalsis, the fluid is sometimes seen at different levels in two segments of the same coil, and on fluoroscopy the levels will be seen to rise and fall(2). If the findings revealed on the scout film of the abdomen are correctly evaluated, the diagnosis of dynamic intestinal obstruction as well as its exact location at a definite point in the small or large bowel is possible without the administration of the opaque barium meal. The meal should not be given in the presence of mechanical obstruction unless a 2. Hnever. Andreas: Roentgen Diagnosis of Intestinal Obstruction, Acta Radiol. IOMOO-482 (Nov. 30) l«>38. Miller-Abbott tube has been successfully introduced into the intestine, because the risk of making a partial obstruction complete is too great. It is often possible, without giving the meal, to locate the point of obstruction from scout films alone, and by correlation with the clinical history to arrive at a conclusion concerning its cause. Small bowel obstruction (fig. 1) When the obstruction is in the small bowel, the characteristic small bowel pattern — variously described as "step-ladder," "stacked-coin," or "herring-bone" pattern— will be seen, and the dilated loops of bowel will be found in the mid-abdomen. The obstructed loop or loops will often assume an inverted "U" shape because of increased tonus. The air bubble above the fluid level will be greater in width than in height, and the bowel distal to the point of obstruction will be empty, free of gas or fluid, and collapsed. If peritonitis has developed, with its associated accumulation of free fluid in the peritoneal cavity, the loops of dilated bowel will be seen to be separated farther than is normal. Large botvel obstruction (fig. 2) If the obstruction is in the large bowel, the dilated loops of bowel with fluid levels are
Object Description
Rating | |
Fixed Title * | NCHH-17: North Carolina Medical Journal [1940-2001] |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1945 |
Identifier | NCHH-17-006 |
Form General | Periodicals |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 6 |
Health Discipline | Medicine |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-006.pdf |
Document Sort | all; nchh-17 |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-006 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
Description
Fixed Title * | Page 316 (image) |
Document Title | North Carolina Medical Journal [1940-2001] |
Subject Topical Other | Public Health -- Periodicals.; Physicians -- North Carolina -- Directory.; Societies, Medical -- North Carolina -- Periodicals. |
Description | Includes Transactions of the Society, -1960; 1961- , Transactions issued separately, bound in.; Includes Transactions of the auxiliary to the Medical Society of the State of North Carolina and Proceedings of the North Carolina Public Health Association. Official organ of the Medical Society of the State of North Carolina, 1940-May 1972; of the North Carolina Medical Society, June 1972-. Vols. for 1940-May 1972 published by the Medical Society of the State of North Carolina; June 1972- by the North Carolina Medical Society. |
Contributor | Medical Society of the State of North Carolina. Transactions.; Medical Society of the State of North Carolina.; North Carolina Medical Society.; North Carolina Medical Society. Transactions.; North Carolina Public Health Association. Proceedings. |
Publisher | [Winston-Salem] : North Carolina Medical Society [etc.], 1940- |
Repository | University of North Carolina at Chapel Hill. Health Sciences Library. |
Host | University of North Carolina at Chapel Hill |
Date | 1945 |
Identifier | NCHH-17-006-0328 |
Form General | Periodicals |
Page Type | all; all images; x-ray; article |
Language | English |
Rights | This item is part of the North Carolina History of Health Digital Collection. Some materials in the Collection are protected by U.S. copyright law. This item is presented by the Health Sciences Library of the University of North Carolina at Chapel Hill for research and educational purposes. It may not be republished or distributed without permission of the Health Sciences Library. |
Filename | northcarolinamed61945medi_0328.jp2 |
Digital Collection | North Carolina History of Health Digital Collection |
Sponsor | The North Carolina History of Health Digital Collection is an open access publishing initiative of the Health Sciences Library of the University of North Carolina at Chapel Hill. Financial support for the initiative was provided in part by a multi-year NC ECHO (Exploring Cultural Heritage Online) digitization grant, awarded by the State Library of North Carolina, and funded through the Library Services and Technology Act (LSTA). |
Volume Number | 6 |
Issue Number | 7 |
Page Number | 316 |
Health Discipline | Medicine |
Full Text | 316 NORTH CAROLINA MEDICAL JOURNAL A.pril, 1945 Intestinal Obstruction The roentgen diagnosis of this condition is based primarily on the demonstration of fluid levels in the gas-distended gut. These may be shown on a scout film of the abdomen made with the patient in the erect or lateral decubitus position. The immediate results of obstruction are the accumulation of intestinal contents proximal to the point of obstruction and emptying of the intestine distal to this point. Gas accumulates within a few hours, thus supplying the condition necessary for the formation of fluid levels. The chief roentgen findings in cases of acute intestinal obstruction are dilated, gas-filled loops of bowel showing fluid levels. Because of increased peristalsis, the fluid is sometimes seen at different levels in two segments of the same coil, and on fluoroscopy the levels will be seen to rise and fall(2). If the findings revealed on the scout film of the abdomen are correctly evaluated, the diagnosis of dynamic intestinal obstruction as well as its exact location at a definite point in the small or large bowel is possible without the administration of the opaque barium meal. The meal should not be given in the presence of mechanical obstruction unless a 2. Hnever. Andreas: Roentgen Diagnosis of Intestinal Obstruction, Acta Radiol. IOMOO-482 (Nov. 30) l«>38. Miller-Abbott tube has been successfully introduced into the intestine, because the risk of making a partial obstruction complete is too great. It is often possible, without giving the meal, to locate the point of obstruction from scout films alone, and by correlation with the clinical history to arrive at a conclusion concerning its cause. Small bowel obstruction (fig. 1) When the obstruction is in the small bowel, the characteristic small bowel pattern — variously described as "step-ladder" "stacked-coin" or "herring-bone" pattern— will be seen, and the dilated loops of bowel will be found in the mid-abdomen. The obstructed loop or loops will often assume an inverted "U" shape because of increased tonus. The air bubble above the fluid level will be greater in width than in height, and the bowel distal to the point of obstruction will be empty, free of gas or fluid, and collapsed. If peritonitis has developed, with its associated accumulation of free fluid in the peritoneal cavity, the loops of dilated bowel will be seen to be separated farther than is normal. Large botvel obstruction (fig. 2) If the obstruction is in the large bowel, the dilated loops of bowel with fluid levels are |
Digital Format | JPEG 2000 |
Print / Download PDF Version | http://archives.hsl.unc.edu/nchh/nchh-17/nchh-17-006.pdf |
Document Sort | all; nchh-17 |
Article Title | Roentgenological Aids In The Differential Diagnosis Of Acute Abdominal Conditions |
Article Author | J. P. Rousseau; L. M. Morris |
Volume Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/identi/searchterm/NCHH-17-006 |
Title Link | http://dc.lib.unc.edu/cdm/search/collection/nchh/field/documa/searchterm/NCHH-17 |
Catalog Record link | http://search.lib.unc.edu/search?R=UNCb1306322 |
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