Bowel Obstruction

	Small bowel obstruction	Large bowel obstruction
Clinical
Symptoms * the four cardinal symptoms of bowel obstruction are: - vomiting - colicky abdominal pain - constipation - abdominal distension	Less distension, vomiting occurs earlier, pain is higher in the abdomen	More distension, vomiting occurs later and feculent, pain is lower in the abdomen
Radiologic features	Small bowel features: Valvulae conniventes – folds that cross the lumen completely Normal features of small bowel: - No more than 3 mm wall thickness - Generally no more than 3 air fluid levels - No more than 3 cm diameter	Large bowel features: Haustrations: incomplete crossing of folds across the lumen
3,6,9 rule	Maximal normal diameter in small bowel 3 cm Maximal normal diameter in large bowel 6 cm Maximal normal diameter in cecum 9 cm
		In colorectal Carcinoma Left sided tumors: generally presented with altered bowel habit, blood or mucus PR, mass PR Right sided tumors: generally presented with weight loss, anemia, less obstructive symptoms