Differential diagnosis of pediatric small bowel obstruction


Approach to the differential diagnosis of small bowel obstruction:

  • AXR is a good exam to begin the workup of small bowel obstruction to give an overview and to help make the diagnosis of inguinal hernia
  • US is the next step to look for intussusception or appendicitis and occasionally Meckel diverticulum can be seen
  • Upper GI with small bowel follow through can be useful to assess whether an obstruction is partial or complete in cases of suspected abdominal adhesion
  • CT can be useful in determining the etiology of small bowel obstruction in clinically confusing cases
  • In any patient presenting with bilious vomiting, an upper GI should be done to rule out malrotation with midgut volvulus if the patient has no historical reasons or clinical findings to suggest other causes of small bowel obstruction