Bowel-GI - The Piano Sign
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Caption
A 55 year old male came to ED c/o abdomen pain for 3 days associated with abdominal distention and vomiting. He was noted to be tachycardic and his abdominal exam demonstrated tenderness and bulging in the right inguinal area. A curvilinear probe was used to evaluate for bowel obstruction. The clip demonstrates a dilated loop of bowel, "to and fro" movements of bowel content suggesting dysfunctional peristalsis, and the piano sign. The piano sign (or keyboard sign) is essentially visualization of the plicae circularis which is associated with the diagnosis of small bowel obstruction. Dr. Mahmoud S Alsomali EM Resident R4; Saudi Board Of Emergency Medicine; King Saud Medical City; Riyadh KSA