Which of the following investigation is used in diagnosing intestinal obstruction?: (A) Chest X Ray, (B) X ray abdomen supine, (C) X ray abdomen lateral, (D) Barium meal
Answer is B. Obtain plain radiographs first for patients in whom small-bowel obstruction (SBO) is suspected. At least 2 views, supine or flat and upright, are required. Plain radiographs are diagnostically more accurate in cases of simple obstruction. 2 findings predictive of a higher grade or complete SBO: (1) the presence of an air-fluid differential height in the same small-bowel loop and (2) the presence of a mean level width greater than 25 mm. Dilated small-bowel loops with air-fluid levels indicate SBO, as does absent or minimal colonic gas.