Chapter: Abdomen & Pelvis
Diagnosis: Large bowel obstruction
A hepatic flexure stricture is causing large bowel obstruction proximal to this level. Note is made of a dilated, air-filled ascending colon (asterisk) with abrupt cut-off at the hepatic flexure. Coronal reformatted CT (right image) confirms a stricture at the hepatic flexure (black arrows). Also noticed are dilated air-filled small bowel loops, which subsequently also become obstructed. The reason, why some bowel loops contain contrast, some less, and some no contrast (double arrow) is, because the contrast did not have a chance to progress to the more distal loops.
By the way: both, the abdominal radiograph and CT were performed in patient supine position, therefore fluid is layering posterior and air anterior. The CT cut has been performed in a more posterior position, thus showing fluid in the bowel.
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