- To understand the pathophysiology and possible causes of large bowel obstruction - To familiarize radiologists with imaging findings diagnostic of large bowel obstruction - To review the complications of large bowel obstruction and the associated CT features

Large-bowel obstruction (LBO) is an abdominal emergency that, if left untreated, results in high morbidity and mortality rates. The signs and symptoms are often insidious and include abdominal distention, constipation and abdominal pain. The most common radiological diagnostic techniques used in the diagnosis of intestinal obstruction are the simple abdominal X-ray and the abdominopelvic CT. The underlying etiology is age-dependentand may be suggested by specific symptoms and presentation of the patient. The main complications are ischemia and intestinal perforation.

Clinical presentation LBO may develop over a lengthy period but it’s clinical presentation is often acute and includes abdominal pain, constipation and abdominal distention. In the case of acute volvulus the bowel sounds are usually hypoactive, while in vascular compromise/ischemia, patients often exhibit substantial abdominal tenderness. Pathophysiology The visceral pain of intestinal obstruction is due to increased gut peristalsis against the obstruction. Rather than being localized, pain is usually referred towards the midline, reflecting the gut’s embryological origin. Bowel obstruction results in distention of the...

LBO is a common clinical entity in which imaging plays a key role in the identification of etiology, site of obstruction and early detection of complications.

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