Colonic pseudo-obstruction: value of prone lateral view of the rectum.

Abstract

Collection of fluid within the rectum of patients with gas-distended bowel can simulate as obstructive lesion. In 12 patients with suspected distal colonic obstruction on plain radiographs, we obtained 2 additional films comprising a right lateral decubitus view of the abdomen followed by a prone lateral view of the pelvis. Significant gaseous distension of the rectum was achieved in 75% of the 8 patients with pseudo-obstruction. Gaseous filling of the rectum did not occur in any patient with a structural obstructive lesion. In the appropriate clinical setting this approach could exclude the presence of obstruction and avoid unnecessary barium enemas in the majority of patients with colonic pseudo-obstruction.