What are some of the complications of small bowel obstruction?
Perforation and ischaemia are the most feared complications.
Is there any evidence of perforation?
In perforation, gas escapes from the bowel and rises dependently - on a CT, you see it at the anterior surface of the peritoneum. Fluid from the small bowel tends to gather in the pelvis and lower abdomen. Using bone windows is helpful to find small locules of gas.
Same CT stack with annotation of the swirling vessels at the mesenteric root:
- red: aorta and SVA
- blue: SMV