The faeces sign. A CT finding in small-bowel obstruction

The faeces sign is a recently described computed tomography (CT) feature of small-bowel obstruction and is seen as a mottled, faeces-like content within the lumen of the dilated loops above the level of the obstacle. To evaluate its prevalence, significance, and diagnostic value we retrospectively reviewed 94 consecutive cases of small-intestine obstruction studied with CT in the last 6 years. The faeces sign was recognizable in 7 cases (7.4%) and was localized within ileal loops in all these subjects. In 6 of the 7 cases there was a simple and progressive obstruction, while there was a sudden onset with intestinal strangulation in only 1. The faeces sign is due to the intraluminal stagnation of enteric material and is generally recognizable in subjects with subacute obstruction. In our experience it is relatively uncommon. Nevertheless, it seems to be rather specific and may be a valuable accessory feature in the CT study of small-bowel obstruction.