Radiographic features of small bowel obstruction on plain films typically include which finding?

Radiographic features of small bowel obstruction on plain films typically include which finding?

• A. Free air under the diaphragm
• B. Normal radiograph
• C. Dilated colon with gas in rectum
• D. Central abdomen with minimal colonic gas

Answer: (D)

In small bowel obstruction, the plain-film pattern you expect is dilated small-bowel loops that are often centrally located in the abdomen, with little to no gas in the colon. This reflects a blockage proximal to the colon, so contents back up into the small intestine while the colon remains relatively empty. Gas in the colon or a normal radiograph would suggest either partial/early obstruction or a nonobstructive process, not a typical SBO pattern. Therefore, a central abdomen with minimal colonic gas best fits the classic radiographic appearance of a small bowel obstruction.

In small bowel obstruction, the plain-film pattern you expect is dilated small-bowel loops that are often centrally located in the abdomen, with little to no gas in the colon. This reflects a blockage proximal to the colon, so contents back up into the small intestine while the colon remains relatively empty. Gas in the colon or a normal radiograph would suggest either partial/early obstruction or a nonobstructive process, not a typical SBO pattern. Therefore, a central abdomen with minimal colonic gas best fits the classic radiographic appearance of a small bowel obstruction.