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Nausea, Vomiting, and Worsening Pain

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The radiograph shows multiple stacked dilated loops of small bowel. The colon does not appear distended. (A nasogastric tube is also present, and there are degenerative changes in the spine.) Such a finding is typically associated with at least a partial small bowel obstruction, since no definite air fluid levels are noted.

The patient was admitted and made npo. Nasogastric decompression was started, and general surgery consultation was obtained.

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Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon.

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Clinician Reviews - 24(10)
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Radiology, bowel obstruction
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Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon.

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Nandan R. Hichkad, PA-C, MMSc, practices at the Georgia Neurosurgical Institute in Macon.

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ANSWER
The radiograph shows multiple stacked dilated loops of small bowel. The colon does not appear distended. (A nasogastric tube is also present, and there are degenerative changes in the spine.) Such a finding is typically associated with at least a partial small bowel obstruction, since no definite air fluid levels are noted.

The patient was admitted and made npo. Nasogastric decompression was started, and general surgery consultation was obtained.

ANSWER
The radiograph shows multiple stacked dilated loops of small bowel. The colon does not appear distended. (A nasogastric tube is also present, and there are degenerative changes in the spine.) Such a finding is typically associated with at least a partial small bowel obstruction, since no definite air fluid levels are noted.

The patient was admitted and made npo. Nasogastric decompression was started, and general surgery consultation was obtained.

References

References

Issue
Clinician Reviews - 24(10)
Issue
Clinician Reviews - 24(10)
Page Number
17,21
Page Number
17,21
Publications
Publications
Topics
Article Type
Display Headline
Nausea, Vomiting, and Worsening Pain
Display Headline
Nausea, Vomiting, and Worsening Pain
Legacy Keywords
Radiology, bowel obstruction
Legacy Keywords
Radiology, bowel obstruction
Sections
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A 75-year-old woman presents to the emergency department with a three-day history of abdominal pain. She does not recall eating anything unusual. She reports having nausea and vomiting and states that her pain is progressively worsening. Her medical history is significant for hypertension. Surgical history is significant for previous cholecystectomy and total abdominal hysterectomy. She is afebrile, and her vital signs are within normal limits. Her abdomen is soft and diffusely tender, with slightly decreased bowel sounds. No rebound or guarding is present. The rest of her physical examination overall is within normal limits. During the exam, she experiences a couple episodes of bilious vomiting. You order some laboratory studies as well as an abdominal radiograph (shown). What is your impression?
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