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Figure 5.12. Adhesive small-bowel obstruction. (A) Overhead film from a single-contrast enteroclysis shows marked dilatation of the jejunum and some ileum, with no visualization of the distal small bowel or colon consistent with a small-bowel obstruction. (B) Spot film from the same examination demonstrates that the obstruction is due to a crossing defect from an adhesion. (C) CT scan on the same patient demonstrates the dilated small bowel with a mild degree of hazy mesentery at the transition point to relatively collapsed distal small bowel. The bowel at this point shows slight mural thickening and enhancement consistent with a mild degree of ischemia. Other loops of small bowel demonstrate an irregular degree of mural enhancement.

Figure 5.12. Adhesive small-bowel obstruction. (A) Overhead film from a single-contrast enteroclysis shows marked dilatation of the jejunum and some ileum, with no visualization of the distal small bowel or colon consistent with a small-bowel obstruction. (B) Spot film from the same examination demonstrates that the obstruction is due to a crossing defect from an adhesion. (C) CT scan on the same patient demonstrates the dilated small bowel with a mild degree of hazy mesentery at the transition point to relatively collapsed distal small bowel. The bowel at this point shows slight mural thickening and enhancement consistent with a mild degree of ischemia. Other loops of small bowel demonstrate an irregular degree of mural enhancement.

5.13) [45]. The small-bowel enema was also far more accurate than CT imaging in determining the level of the obstruction. Fewer false positive examinations were also noted in patients examined with enteroclysis.

The role of CT imaging in small-bowel obstruction is multifold. First, CT images are needed to make the diagnosis of small-bowel obstruction and to determine its level and etiology. Second, its roles are to

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