Small bowel obstruction (SBO) is one of the more frequent causes of acute abdomen representing 20% of all surgical admission for acute abdominal pain (1). SBO has a mortality rate varying from 3-7% in uncomplicated cases, to around 15% in case of strangulation (2). Outcome depends on an immediate and accurate diagnosis (3) and the main point in the management of SBO is to evaluate if surgery is necessary or not. In the available literature, the role of ultrasound (US) as first approach in patients...

Animal preparation Eight adult male Sprague-Dawley rats were divided in 2 groups: in the Group 1 (n=4), rats underwent a surgical procedure of small bowel ligation followed by 8 hrs macroscopical monitoring; in the Group 2 (n=4), high resolution micro-US scannings (Visualsonics Vevo 2100) were performed before and after small bowel ligation. In both cases, injured bowel was processed for histological analysis. The rats were maintained on a 12/12 h light/dark cycle and allowed free access to food and water. They were anesthetized with Ketamine...

Pathological findings got evident already 20 min after small bowel ligation, when a spastic reflex ileus and a chromatic change of the injured bowel were found. High resolution micro-US imaging, also performed with PW/Color Doppler and LAZR photoacoustic imaging system, gave evidence of increased bowel movement in the proximal loop, little amount of peritoneal free fluid, mild edematous thickness of the injured bowel wall and changing in the Doppler and LAZR signal. These findings got worsen and worsen till the end of the monitoring period...

Active collaboration between radiologist, emergency physicians, and general surgeons is necessary to optimize the diagnostic evaluation and management in SBO. The role of radiologists is to confirm the obstruction, establish the cause, determine the level, and predict whether strangulation is present. The diagnosis of SBO can be made with plain abdominal films in 50-60% of cases. However this technique may be unremarkable in 20% of cases. The role of US has been widely applied to evaluate various abdominal diseases and several articles have dealt with...

A.C.Silva, M.Pimenta,L.S.Guimaraes. Small bowel obstruction: what to look for. RadioGraphics, 2009, Vol. 29:423-439 S. Sarraf-Yazdi, M.L. Shapiro. Small bowel obstruction: the eternal dilemma of when to intervene. Scandinavian Journal of Surgery 2010; 99:78-80. Nicolaou S, Kai B, Ho S, Su J, Ahamed K. Imaging of acute small-bowel obstruction. AJR Am J Roentgenol. 2005;185:1036-44. Ko YT, Lim JH, Lee DH, Lee HW, Lim JW. Small bowel obstruction: sonographic evaluation. Radiology. 1993;188:649-53 Garcia DA, Froes TR, Vilani RG, Guérios SD, Obladen A. Ultrasonography of small intestinal obstructions:...

Dr. Francesca Iacobellis, M.D Second University of Naples Institute of Radiology P.za Miraglia 2, 80138 Naples, Italy. e-mail: [email protected] Tel: +39-081-5665203; Fax: +39-081-5665200.