X-ray in Postoperative Obstruction (Complications)

Figure abdo_28_n.jpg: Abdomen x-ray in a schoolchild with 'surgical abdomen'. Overdistended intestinal segments in the left middle and lower right abdomen, and above them two suggested air-fluid levels are visible. In addition, stool masses in the right lower abdomen are recognizable, and there are only few intestinal loops filled with air. These radiological findings are relatively often encountered in children with obstructive ileus due to adhesions (instead of the expected numerous air-fluid levels, in which an obstructive ileus is obvious). If few such isolated air-fluid levels or overdistended intestinal segments occur combined with pain on palpation and sounds of stenosis on auscultation at the same localization, a postoperative obstruction is also obvious. In infants the suspicion of a postoperative obstruction may be clinically even more difficult; indications for x-rays are intermittent crying, frowning, and visible movements of the intestine (intestinal stiffenings).