Value of CT abdomen and imaging findings in gut obstruction
Keywords:
Gut obstruction,, computed tomography, abdomenAbstract
Objective : The purpose of study was to determine the value of CT abdomen and imaging findings in gut obstruction Method : A retrospective study. The data was collected from all patients with a CT diagnosis of gut obstruction between January 2012 to December 2017 Result : There were 239 patients whom clinical suspicion for gut obstruction and 96 patients were diagnosed this condition by CT abdomen. In 16 patients whom findings on plain abdominal radiographs were normal, the CT scan was positive for obstruction. Cause of small bowel obstruction was evident on CT in 18 patients: volvulus (5), tumor (4), femoral hernia (3), intussusception (3),inflammation (2) and gallstone ileus (1). Adhesions were responsible for the obstruction in 34 of 52 patients in whom the cause was not shown on CT. Cause of large bowel obstruction was evident on CT in all patients: tumor (36), endometriosis (2), post-radiation colitis (1), sigmoid volvulus (1) and umbilical hernia (1) A diagnosis of bowel ischemia was made at surgery in 8 patients and CT diagnosis was correct in 7 patients (sensitivity 87.5%, specificity 100%) Conclusion : CT is sensitive for diagnosing gut obstruction and for determining the location, cause and complication of gut obstruction
References
2. Nicolaou S, Kai B, Ho S, Su J, Ahamed K. Imaging of acute small-bowel obstruction. AJR Am J Roentgenol 2005;
185(4):1036–1044.
3. Maglinte DD, Heitkamp DE, Howard TJ, Kelvin FM, Lappas JC. Current concepts in imaging of small bowel obstruction.Radiol Clin North Am 2003; 41:263-283.
4. Fukuya T, Hawes DR, Lu CC, Chang PJ,Barloon TJ. CT diagnosis of small-bowel obstruction: efficacy in 60 patients. AJR Am J Roentgenol 1992; 158(4):765–769.
5. Frager D, Medwid SW, Baer JW, Molli nelli B, Friedman M. CT of small-bowel obstruction: value in establishing the diagnosis and determining the degree and cause. AJR Am J Roentgenol 1994; 162 (1):37–41.
6. Paulson EK, Thompson WM. Review of small bowel obstruction: the diagnosis and when to worry. Radiology 2015; 275(2):332–342.
7. Boudiaf M, Soyer P, Terem C, Pelage JP,Maissiat E, Rymer R. CT evaluation of small bowel obstruction. RadioGraphics 2001;21(3):613–624.
8. Attard JA, MacLean AR. Adhesive small bowel obstruction: epidemiology,biology and prevention. Can J Surg
2007;50(4):291–300.
9. Jaffe T, Thompson WM, Large bowel obstruction in the adult: Classic radio graphic and CT findings, etiology, and mimics. Radiology: 275(3), June2015:651-663.
10. Zalcman M, Sy M, Donckier V, Closset J, Gansbeke DV. Helical CT signs in the diagnosis of intestinal ischemia in small-bowel obstruction. AJR Am J Roentgenol 2000;175(6):1601–1607.
11. Balthazar EJ, Liebeskind ME, Macari M. Intestinal ischemia in patients in whom small bowel obstruction is
suspected: evaluation of accuracy,limitations, and clinical implications of CT in diagnosis. Radiology 1997;
205(2):519–522.
12. Petrovic B, Nikolaidis P, Hammond NA, Grant TH, Miller FH. Identification of adhesions on CT in small-bowel
obstruction. Emerg Radiol 2006; 12(3):88–93; discussion 94–95.
