Mystery Tour

Last updated (26 October 2003)

Obstructed Click on the image to download a larger version
This abdmominal film was taken in a 55 year old lady who presented to the accident department with intermittant abdominal distension, pain and vomiting. Do you see anything of note?

The answer

There is evidence of distended small bowel and an abnormal gas pattern over the liver.

What the student may say

This is a scout film from an abdominal CT scan. I cannot read the name of the patient, the date of the CT or the patients date of birth. The gas pattern in the small bowel would suggest that this is a supine film, as is usual for CT scans.

The bowel appears distended with gas. This is most evident in the central abdomen. This distended bowel is the small bowel which shows the characteristic stack of coins appearance due to the valvualae coniventes. In addition there is a peculiar gas pattern visible over the liver.

I would be concerned about the possibility of intestinal obstruction


Adrian P. Ireland