Step ladder pattern is characteristic of
Imaging findings of small bowel obstruction Conventional radiographyLoops proximal to the point of obstruction will become dilated and fluid-filledUsually greater than 2.5-3 cm in sizeThe absence of, or dispropoionately smaller amount of, gas in the colon, especially the rectosigmoidLoops of the small bowel may arrange themselves in a step-ladder configuration from the left upper to the right lower quadrant in a distal SBO (small bowel obstruction)Mostly fluid-filled loops of bowel may demonstrate a string-of-beads sign caused by the small amount of visible air in those loopsCTDilated and fluid-filled loops of small bowel proximal to the obstruction and collapsed loops of small bowel and/or colon distal to the obstructionSmall bowel faeces sign is seen in SBO because of the intermixing of air with material that is static in an obstructed small bowel, resembling the appearance of faecesWhile adhesions are not imaged per se, their presence can be inferred by a rapid change in bowel calibre without any other causes of obstruction Signs of strangulation include thickening of the bowel wall, increased attenuation of the bowel wall, stranding of the adjacent small bowel mesentery or pneumatosis intestinalisCT may demonstrate tumours, Crohn's disease, gallstone ileus, hernias, closed-loop obstructions (Ref: Grainger and Allison&;s diagnostic radiology 6th edition, chapter 25)
Acute appendicitis
Diaphragmatic hernia
Intestinal perforation
Small bowel obstruction
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