Reasons for dilated bowel
obstruction (volvulus, hernia
ileus
malabsorption
ischemia/infarction
Small vs large intestine dilation
small - more central
large - more peripheral
Free air in abdomen
No symptoms - benign (post op, pneumatosis intestinalis)
Symptomatic - perforation (ulcer, appendix, diverticulum, cancer)
Rigler’s sign
air on both sides of bowel wall - bowel wall well-defined
Thick walled bowel causes
water pus blood cells fat
preservation of layered architecture - suggestive of benign causes
Imaging with acute upper GI bleeding
NOT BARIUM!
endoscopy