Degree of bowel distension on plain-radiographs--a surgical-radiological study of new criteria in mechanical intestinal obstruction.

Three hundred sixty clinical cases which presented with or without mechanical intestinal obstruction were evaluated in order to discover reliable quantitative and qualitative criteria for pre-surgical x-ray diagnoses. It was discovered that small bowel distension of above 1.0 (ratio) together with obvious gas fluid level is usually indicative of small bowel obstruction, while large bowel distension of above 1.5 (ratio) together with obvious gas fluid level is usually indicative of large bowel obstruction. Subsequent surgery confirmed that there exists a correlation between the degree of small bowel distension seen on radiographs prior to surgery and the actual small bowel distension secondary to small bowel obstruction measured during surgery. The present results may be diagnostically useful in the radiological differentiation of mechanical intestinal obstructions from other abdominal conditions.