Adynamic Ileus

Radiographic – Fluoroscopy

• Fluoroscopic appearance of adynamic ileus is very similar to SBO, with dilated loops of small bowel and normal fold pattern.

• Fold pattern may, however, be altered in some diseases that cause adynamic ileus.  For example, sprue may present with jejunalization in addition to dilatation.  Scleoderma may present with pseudodiverticula and hidabound loops of small bowel.  Ischemia may present with fold.

• A transition zone may be appreciated if the ileus is localized.

Adynamic ileus in scleroderma, manifest as diffuse dilatation.  Note the pseudodiverticula and featureless pattern of the loops of small bowel.

Diffuse dilatation of loops in chronic idiopathic intestinal pseudo-obstruction.