myRadiologist

Symptom

Suspected small bowel obstruction

ConsiderationsRichard Wasley, MD

abdominal xray should be performed as it can find free air, SBO or foreign body. It should not delay definitive CT or MRI though. Small bowel series usually not first line as study may take hours and CT cannot usually be performed for hours to days later

CT is mainstay. Oral contrast not usually used as poorly tolerated by patient, wastes time, does not add dx value and can even complicate situation. MR ok. CT enteroclysis for chronic or recurring symtoms. US not very useful.

§Suggested imagingIn listed order

  1. 01CT abdomen and pelvis with IV contrastCPT 74177
  2. 02CT abdomen and pelvis without IV or oral contrastCPT 74176
  3. 03MRI abdomen with gadoliniumCPT 74183
  4. 04abdominal xray seriesCPT 74020
  5. 05CT enteroclysisCPT 74177