[Sabio]

Whenever you see a case of tinkly bowel sounds (exaggerated and sounds like a bell under water) + abdominal distension then think jejunal or ileal obstruction (not dudenal or large bowel).

Common causes in adults include:

• Hernias
• Adhesions
• Tumor
• Foreign body
• Meckle's diverticulum
• Crohn's disease
• Ascaris infection
• Midgut volvulus
• Intussusception