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Imaging manifestations of simple small intestinal obstruction
The typical X-ray manifestations of simple small intestinal obstruction are: intestinal cavity expansion above obstruction, pneumatosis and hydrops. The uneven liquid level can be seen in a discontinuous stepped arrangement on the vertical film, and the expanding intestinal cavity can be seen on the horizontal film. At this time, we can clearly observe the degree of intestinal cavity expansion and the mucosal structure of intestinal cavity. Generally speaking, the mucosal fold wall of jejunum is annular or spring-shaped and spans the intestinal cavity, while the ileum is relatively smooth and easy to bend and gather to form coffee beans. Be careful not to be misdiagnosed at this time.

Judging the position of obstruction: the swollen stomach and duodenum have a large liquid level on the longitudinal film of duodenal obstruction. However, it should be noted that when there is more water in the stomach and the expansion is obvious, it is easy to ignore the distended duodenum without gas. At this time, it is often misdiagnosed as acute gastric dilatation or pyloric obstruction, which deserves attention. At this time, we should observe and rotate the body position under fluoroscopy to show the liquid level or gas accumulation in the duodenum, which is of great significance to the diagnosis of duodenal obstruction. Empty intestinal obstruction, a continuous annular mucosal fold wall across the intestinal cavity can be seen in the expanded intestinal cavity, which is located on the left side of the upper middle abdomen. On the vertical film, only a small amount of liquid level can be seen in the middle abdomen, but it is not difficult to judge if there is no inflatable intestinal curvature or there is liquid level below. Obstruction in the middle and lower ileum can be seen with different liquid levels in the longitudinal photos, and there are often liquid levels below the iliac crest line, and the liquid levels moving up and down can often be seen under fluoroscopy. On the supine radiograph, it can be seen that the expanding empty ileum fills the abdominal cavity, which is often arranged in a long span, which is different from strangulated small intestinal obstruction.

Simple intestinal obstruction can be divided into complete intestinal obstruction or incomplete intestinal obstruction, which is very helpful for clinical treatment. After the diagnosis of small intestinal dilatation, the distal intestinal cavity of small intestinal obstruction, including small intestine and colon, collapses and has no gas, especially when the colon has no gas for a short time, it can be diagnosed as complete simple small intestinal obstruction; When gas is found in the colon when expanding the swollen small intestine, and the colon gas still exists for a short time, it can generally be diagnosed as incomplete simple intestinal obstruction.

It is often difficult to judge the cause of the blockage. Unless there is a clear clinical history of abdominal surgery, the estimation of obstruction is related to postoperative adhesion. Or see scattered calcifications in the photos, it can be inferred that obstruction is related to tuberculous peritonitis; Or see twisted round ascaris in the obstruction, and the diagnosis of ascaris obstruction is clear.