Radiological Features
Left: Plain abdominal film showing features of a large bowel obstruction. Note distribution of the gas and the haustral pattern.
Right: Gastrografin enema in same patient showing free flow to caecum indicating pseudo-obstruction.
Plain films will show a distended colon similar to that seen in a mechanical obstruction. Therefore water contrast (e.g.gastrografin) can be helpful when colonic pseudo-obstruction is suspected in ruling out a mechanical cause. The beneficial features of using water contrast are:
- Low viscosity
- Hyperosmolarity effect is often therapeutic (colonic motility returns)
Barium enemas are not advised due to:
- Higher viscosity
- Dangerous if peritonitis present
- Preferable not to use when surgery is required
