15 year old DSH

Discussion

A barium enema was performed (see additional images), which confirmed that the dilated bowel was not large intestine in origin. The mineral material in the small intestine oral to the obstruction is characteristic of a “gravel sign”, or accumulation of particulate matter that is too large to pass through the intestinal lumen at the site of obstruction.
Ultrasound was performed; however, visibility was limited due to the large amount of attenuating material in the colon.