Small bowel obstruction is one of the most common reasons for hospital admissions – accounting for approximately 15% of patients admitted from the Emergency Department to the Surgical Unit.1 It may be classified as a complete/high grade obstruction with no fluid or gas beyond the transition point, an incomplete/partial obstruction with some fluid or gas beyond the transition point, a closed-loop obstruction with 2 points of obstruction which may lead to volvulus and strangulated obstruction which can result in bowel ischaemia and potentially fatal complications...

A retrospective study of consecutive patients who underwent conventional abdominal radiography at the Gold Coast University Hospital over the span of 2 months – from 1st February to 31st March 2016, was performed. A total of 636 conventional abdominal radiographic examinations were performed in that period. 355 examinations did not include an erect abdominal radiograph and were excluded in this study – most commonly because: 118 examinations were performed to assess the radio-opacity of renal calculus, 37 for the position of medical devices like ureteric...

The results are shown on Fig. 4 . The prevalence of small bowel obstruction in this study is 11.6% - 26 out of 225 patients. 1 case was confirmed in surgery where adhesions were found. 17 cases were diagnosed based on CT abdomen/pelvis findings and 8 were clinically diagnosed and conservatively managed. The sensitivity of supine abdominal radiographs Fig. 5 Fig. 6 Fig. 7 Fig. 8 was 88.5% (23/26) whilst the sensitivity of erect abdominal radiographs Fig. 9 Fig. 10 Fig. 11 Fig. 12 was...

Within the limitations of this study, a mild improvement in the sensitivity of abdominal radiography in the diagnosis of small bowel obstruction is noted with the addition of an erect examination. However, the low specificity of erect abdominal radiographs also has to be taken into account especially when abdominal radiography is most frequently used as a screening modality to exclude the need for emergency surgery or further imaging. Further investigations with a larger, prospective study where all patients with suspected small bowel obstruction undergo both...

Dr Han Tie MBBS Radiology Registrar Gold Coast University Hospital The University of Queensland School of Medicine Contact: [email protected] Dr Patrick Edwin MBBS FRANZCR Consultant Radiologist Gold Coast University Hospital Southport, Queensland

Taylor M, Lalani N. Adult small bowel obstruction. Academic Emergency Medicine. 2013 June, Volume 20(6): p527-544. Cheadle W, Garr E, Richardson J. The importance of early diagnosis of small bowel obstruction. Annals of Surgery. 1988, Volume 54: p565-569. Thompson W, Kilani R, Smith B et al. Accuracy of abdominal radiography in acute small bowel obstruction: Does reviewer experience matter? American Journal of Roentgenology. 2007 March, Volume 188(3): p233-238. Paulson E, Thompson W. Review of small bowel obstruction: The diagnosis and when to worry. Radiology. 2015...