Small Bowel Faeces Sign

A finding on abdominal CT in patients with small bowel obstruction, which is defined as presence of heterogeneous solid faeces-like material mixed with gas bubbles in the lumen of dilated loops of small bowel proximal to the site of obstruction. The sign is most prominent at the zone of transition from the dilated to the collapsed part of the small bowel, and is usually caused by stasis within the obstructed loop, which allows more time for fluid absorption from the bowel and accumulation of undigested food particles. This sign is seen in mechanical small bowel obstruction due to adhesions, hernias, tumours, and inflamed stenosis
DiffDx Mottled material with air collections within the small bowel may occur in infections or metabolic bowel disease, rapid jejunostomy tube feedings or bezoars. Faeces may be found in non-dilated distal ileal loops due to reflux of faecal material from an incompetent ileocaecal valve