“Balloons-on-strings” sign

Excerpt

“Balloons-on-strings” sign has been used for diagnosis of closed-loop small bowel obstruction and describes the dilated small bowel segments (“balloons”) within the closed loop tethered by stretched mesenteric vessels (“strings”) [1]. Closed-loop obstruction occurs when a bowel loop of variable length is occluded at two adjacent points along its course [2]. Most commonly, the closed loop is caused by a single adhesive band, an external or internal hernia, or metastatic and primary tumors of the small bowel [1]. Congenital or iatrogenic defects of the mesentery may also trap a segment of the small bowel, rarely resulting in a closed-loop obstruction [3]. Small bowel within the closed loop continues to secrete fluid and become markedly distended, which can impair venous drainage and cause the ischemia [3]. …