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Small bowel obstruction and large bowel obstruction account for approximately 20% of cases of acute abdominal surgical conditions. The role of the radiologist is to answer several key questions: Is obstruction present? What is the level of the obstruction? What is the cause of the obstruction? What is the severity of the obstruction? Is the obstruction simple or closed loop? Is strangulation, ischemia, or perforation present? In this presentation, the radiologic approach to and imaging findings of patients with known or suspected bowel obstruction are presented.

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The yearly percentage of each category relative to the total number of radiology-related suits was determined, and then each group was furthen divided by specific diagnosis or incident.RESULTS. Along with all medical malpractice lawsuits, radiology-related suits rose dramatically until 1985, when there was a marked but temporary decline caused by tort reform measures enacted in Illinois. Since then, lawsuits have resumed their annual upward climb, although the overall percentage related to radiology has remained relatively constant (1 0-1 5%). The relative number of radiology-related lawsuits in specific categories has changed over the past two decades: the percentages of slip-and-fall, radiation oncology, and miscellaneous cases have decreased, but percentages for the remaining three groups have increased. Lawsuits related to missed diagnoses, which account for the largest category of radiology-related cases, have increased from 34% to 47% of the total. The greatest increase in this category is for breast cancer. Lawsuits claiming injury from complications, the largest subgroup of which is angiography, have grown slightly, but cases alleging failure to order a radiologic examination have shown the greatest percentage increase in the 20-year period, growing from 20% in 1975-1979 to 30% in 1990-1994. This rise is attributed to the greater number of claims involving mammography, CT, MR imaging, and angiography. The growth in failure-to-order lawsuits will have important ramifications as managed care and health reform proposals attempt to limit use of radiologic services.CONCLUSIONS. Notwithstanding the fact that tort reform measures in Illinois decreased the frequency of malpractice litigation temporarily in 1 985 and will likely do so again in 1995, medical malpractice is likely to continue to plague radiologists unabatedly for many years to come.

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Small bowel neoplasms comprise only 1% of gastrointestinal neoplasms. Despite their rarity, it is important to diagnose small bowel tumours early to maximize patient survival.