QuestionSBA
QuestionChoice
A barium enema may be used in large bowel obstruction but is unlikely to be used in the investigation of small bowel obstruction, as barium is unlikely to reach the small bowel. Furthermore, barium studies are contraindicated in perforation so it is important to rule this out first.
10000255
e
Barium enema
QuestionChoice
This is a case of small bowel obstruction as indicated by the bilious vomiting, total constipation and abdominal pain. The BMJ and American College of Radiology both state that abdominal CT scans are the investigation of choice for a definitive diagnosis of small bowel obstruction. This is due to superior sensitivity as well as the ability to detect aetiology.
10000251
a
Abdominal CT scan
QuestionChoice
Although an abdominal X-Ray is a good initial investigation, plain radiographs lack sensitivity, especially in the early stages of bowel obstruction.
10000252
b
Abdominal X-Ray
QuestionChoice
A colonoscopy may be used as part of therapeutic management but is unlikely to feature in the acute phase of investigation.
10000254
d
Colonoscopy
QuestionChoice
Although MRI scans can provide strong soft tissue contrast and do not expose the patient to radiation, in the acute setting these investigations are too time-consuming to be appropriate.
10000253
c
Abdominal MRI
Concept
Chapter
2693
3729
Small Bowel Obstruction
Topic
135
General surgery
12597
A 61-year-old male presents to the emergency department with a 4-hour history of diffuse central abdominal pain and bilious vomiting. He has not passed stool or flatus in 3 days.

Which of the following is the best diagnostic investigation?
a