Abdominal Ultrasound Normal Bowel Vs Small Bowel Obstruction Image Appearances | Dilated Bowel USG

Abdominal Ultrasound Normal Bowel Vs Small Bowel Obstruction Image Appearances | Dilated Bowel USG

Symptoms:
Abdominal discomfort/pain
Abdominal distension
Nausea/Vomiting: Vomitus often contains bile (greenish-yellow) and may become feculent (foul-smelling) in prolonged or distal obstructions.
Severe Constipation: Inability to pass flatus or stool is a key symptom in complete obstruction. Partial obstructions may allow for occasional bowel movements.

Normal Bowel:
Thickness: Normal small bowel wall thickness is typically less than 3 mm when the bowel is distended. If the bowel is collapsed, the wall may appear thicker, but this is normal in a non-distended state.
Diameter: Less than 3 cm

Layers:
Hyperechoic (bright): Interface of the superficial mucosa and the lumen.
Hypoechoic (dark): Deep mucosa.
Hyperechoic (bright): Submucosa.
Hypoechoic (dark): Muscularis propria.
Hyperechoic (bright): Serosa.

Small Bowel Obstruction:
Dilated fluid filled hypoechoic bowel (Diameter greater than 3 cm)
To and fro appearance of intraluminal contents (Hyperperistalsis, early obstruction)
Decreased/absent peristalsis (Late obstruction/ischemia)
Prominent hyperechoic valvulae conniventes (intestinal folds)
Hypoechoic free fluid outside bowel loops (indicates bowel ischemia/infarction)
Tanga Sign: Triangular shape of hypoechoic free fluid between bowel loops.
A transition from dilated bowel loops proximally to collapsed bowel distally is an important finding.