What does the presence of fluid and air in the small bowel indicate?

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Last updated: February 15, 2025View editorial policy

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Differential Diagnosis for Fluid and Air in Small Bowel

  • Single most likely diagnosis
    • Small Bowel Obstruction (SBO): This is the most common cause of fluid and air in the small bowel, as it leads to a buildup of intestinal contents and gas proximal to the obstruction site.
  • Other Likely diagnoses
    • Ileus: A condition where there is a temporary halt of the normal contractions of the bowel muscles, leading to a buildup of fluid and gas.
    • Inflammatory Bowel Disease (IBD): Conditions like Crohn's disease or ulcerative colitis can cause inflammation and narrowing of the bowel lumen, leading to fluid and air accumulation.
    • Gastroenteritis: Infections of the bowel can cause inflammation, leading to fluid and gas buildup.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Bowel Ischemia: A condition where the blood supply to the bowel is compromised, leading to tissue death. This is a medical emergency that requires prompt diagnosis and treatment.
    • Bowel Perforation: A hole in the wall of the bowel, which can lead to peritonitis and sepsis if not promptly treated.
    • Intussusception: A condition where a part of the bowel telescopes into another part, leading to obstruction and potentially ischemia.
  • Rare diagnoses
    • Small Bowel Diverticulitis: Inflammation of a diverticulum (a pouch) in the small bowel wall, which can cause fluid and air accumulation.
    • Small Bowel Tumors: Neoplasms in the small bowel can cause obstruction or narrowing, leading to fluid and air buildup.
    • Foreign Body Obstruction: Obstruction of the small bowel by a foreign object, such as a swallowed item.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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