Which pattern on abdominal radiograph is suggestive of intestinal obstruction?

Ans. D. All of the aboveThere are 4 patterns that may be seen on abdomen radiograph which suggest intestinal obstruction. The classical is multiple air fluid levels which is also known as step ladder pattern. However, if most of the dilated bowels are filled with fluid then residual air bubbles get trapped between the fluid and bowel wall giving string of beads appearance. If all the dilated bowel loops are filled with fluid the there is no air and we get diffuse ground glass appearance.These 3 patterns are common in small bowel obstruction. However, if there is large bowel obstruction like in volvulus then the colon is overdistended with air with minimal fluid giving grossly distended air filled colon appearance.