-Actual_Problems_of_Emergency_Abdominal_Surgery-_ed._by_Dmitry_Victorovich_Garbuzenko

the use, as marker of ischemia with valuable results, of intestinal fatty acid binding protein,

connected to necrotic enterocytes [29].

The third step of our assessment of intestinal obstruction can allow the achievement of more

defined diagnosis.

9.2. Plain radiography

About some imaging modalities, plain radiography is mostly employed. This is very practical

and useful because it can confirm basic diagnosis of intestinal obstruction [30]. Usually, there

are only few data useful for the distinction between mechanical or dynamic obstruction.

Moreover, the plain radiography is widely available and less expensive; its regular perform‐

ance requires an upright position of patients; the lateral position is a makeshift solution. The

supine position shows insufficient results for diagnosis, only bowel distension. The findings

of plain radiography in bowel obstruction are as follows:

• Multiple air fluid levels, more evident based on upright position;


• Dilatation of intestinal segments proximal the obstacle and collapse in distal bowel.

Figure 5. Plain radiography: small bowel obstruction.

28 Actual Problems of Emergency Abdominal Surgery