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Article
October 1948

EARLY DIAGNOSIS AND ROENTGEN MANIFESTATIONS OF OBSTRUCTION OF SMALL BOWEL

Author Affiliations

KANSAS CITY, MO.
From the Surgical Service, Research Clinic and Research Hospital.

Arch Surg. 1948;57(4):460-469. doi:10.1001/archsurg.1948.01240020467003
Abstract

THE PURPOSE of this discussion is to emphasize the early clinical manifestations of adhesive obstruction of the small bowel and to call attention to the value of a roentgenogram of the abdomen in the diagnosis, differentiation and localization of the obstruction. The clinical indications of obstruction, of the small bowel are definite and characteristic. They are unlike any other form of abdominal colic and present none of the manifestations of localized disease in either of the four quadrants of the abdomen.

The symptoms and physical signs may be divided into three characteristic manifestations, and they may well be called the "big three" of small bowel obstruction.

They are pain, peristalsis and borborygmus. Although they are often repeated clinical entities and are didactic repetitions, they are worthy of repeated emphasis, because it is only by repetition that fundamental principles of disease become a part of clinical knowledge. Through this process not

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