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Small bowel faeces sign.

The presence of faeculant material (colonlike material mixed with gas resembling stool) in the lumen of the distended (more than 2.5 cm) small bowel on computed tomography (CT) is defined as small bowel faeces sign (Fig. 1). (1) It is due to intraluminal stagnation of the enteric contents complicated by bacterial overgrowth and water absorption.

It is an uncommon but highly specific sign of small bowel obstruction (SBO) on CT scan of the abdomen, particularly in patients with low-grade or intermittent obstruction. (2) The adjacent transition zone and the distal collapsed bowel loops indicate the level of obstruction. The most common cause of the SBO is adhesions. Other common causes are inflammation, tumours and hernias. Small bowel faeces sign may also indicate severe metabolic or infectious pathology of the small bowel.

The clinical signs of SBO are difficult to distinguish from local or generalised paralytic ileus; therefore an early radiological diagnosis is very important.


(1.) Mayo-Smith WW, Wittenberg J, Bennett GL, Gervais DA, Gazelle GS, Mueller PR. The CT small bowel faeces sign: description and clinical relevance. Clin Radiol 1995; 50: 765-767.

(2.) Catalano O. The faeces sign: a CT finding in small bowel obstruction. Radiology 1997; 37: 417-419.

Amarjit Kaur Bajwa, MB BS, FCRad (Diag) SA

Department of Diagnostic Radiology, Chris Hani Baragwanath Hospital,

University of the Witwatersrand, Johannesburg
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Title Annotation:TODAY'S TWO SIGNS
Author:Bajwa, Amarjit Kaur
Publication:South African Journal of Radiology
Article Type:Brief article
Geographic Code:6SOUT
Date:Dec 1, 2007
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