History
57 year old female with abdominal pain, nausea, vomiting.
Exam
KUB/supine abdomen, upright abdomen, upright chest
Impression
There is dilatation of multiple loops of small bowel with air-fluid levels likely from distal obstruction. There is pneumatosis of multiple loops of small bowel which could indicate ischemia. There is no free air or portal venous gas. A CT scan is recommended for further evaluation.
Recommendations
Notify the clinical team immediately and verbally about findings of SBO and pneumatosis. Consider CT scan, surgical consult.