Clinical Correlation For Non Specific Bowel Gas Pattern On X-ray

Non specific bowel gas pattern on X-ray is a sometimes used by radiologists when the findings are not suggestive of a specific diagnosis or are not normal. This term falls between normal and bowel obstruction or other abnormality. The term is sometimes combined with clinical correlation is needed by the radiologist.

Clinical correlation means to correlate the findings on the X-ray with the patients symptoms and clinical presentation. The radiologist is alerting the clinical referring doctor that the findings are not a clear diagnosis and that the finding may mean something if it fits the symptoms and suspected diagnosis of the patient.

The non specific bowel gas pattern often has findings that are a little abnormal or can sometime be normal but a bit outside the range of the radiologists expectation of the way normal bowel looks like. There may be a few dilated air filled loops, or some air-fluid levels. There may be a bunch of dilated bowel throughout but not clearly indicating obstruction.

The radiologist does not have the benefit of seeing the patient in person so he does not know how the patient is doing. If this is a 20 year old healthy patient coming for a little belly pain, then the non specific bowel gas pattern likely means nothing. If however, this is a 60 year old with multiple prior surgeries, abdominal pain, and vomiting, then a non specific bowel gas pattern becomes more concerning for bowel obstruction.

The abdominal X-ray is not very good at picking up bowel obstruction in all cases. In fact, even a normal abdominal X-ray does not exclude bowel obstruction. An abdominal X-ray only allows us to see bowel loops which are filled with gas. If there is obstruction with multiple bowel loops filled with fluid, then we may not catch it.

It is therefore very important for the clinical doctor to correlate the patients clinical condition with the X-ray finding. If there is suspicion for bowel obstruction, then it is best for the clinical doctor to order a CT scan. This study is much better for detecting bowel obstruction and other abnormalities of bowel since all the bowel is seen.

Some doctors will start with an X-ray because it’s quick and inexpensive way to screen the patient. It is therefore critical for the patient’s clinical doctor to remember to treat the patient, and not the imaging findings. This is especially true for abdominal X-rays which are not great at picking up bowel abnormalities.