Does not suggest bowel obstruction as a possible diagnosis
Average candidate
Describes all X-ray features succinctly and accurately with a systematic approach and states that the large bowel is dilated likely indicating
obstruction
Suggests performing an ERECT chest X-ray in this context
Is aware of the causes and management of (large) bowel obstruction
Good candidate
Succinctly describes the radiological features of large bowel obstruction, suggesting the descending colon as the level of disease
Without prompting offers a management plan of 'drip and suck' (IV fluids and naso-gastric tube insertion) in the context of general
resuscitation
Suggests CT as a definitive radiological test
Makes a sensible suggestion regarding the purpose of the stent
Large bowel obstruction
There are very few abdominal images you are likely to be shown in a radiology examination. If you can't diagnose obstruction radiologically you will fail the station.
Remember you are not being tested just on radiology skills but also on your ability to plan management. Don't wait to be asked what you would do in this setting, go ahead and tell the examiner your differential diagnosis and how you and your team would proceed.
You may not have come across devices such as the colonic stent before. If this happens in any part of the examination process, don't panic. Try to make sensible suggestions about what it could be and how it fits with the clinical scenario.
Remember the examiner is on your side and the scenario is not trying to catch you out.
