Colonic ileus and its differential roentgen diagnosis.

Abstract

Mindful of the inadequacy of the existing roentgen criteria of colonic ileus, a systematic analysis of the plain roentgenogram findings on 50 such cases was undertaken, with special emphasis on the patterns of colonic dilatation pertaining to the acuteness or chronicity of the process and the nature of the colonic contents. While its pathogenesis varies, colonic ileus did present diagnostic features. These are: continuous gaseous dilatation; minimal fluid; preserved regular haustrations; thin well defined septa; smooth inner colonic contour; and normal consistency of the fecal contents.Concurrent study of 70 cases of low colonic obstruction due to carcinoma or diverticulitis indicated the validity of certain criteria which favor obstruction. These are: noncontinuous gaseous colonic distention; fluid-filled right colon; accentuation of haustrations with numerous closely packed septa or loss or shallowness of haustrations; large amounts of fecal retention; thickened ill defined irregular septa; ragged inner...