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Related Experiment Videos

[Closed loop intestinal obstruction: role of computerized tomography].

F Barbiera1, R Ciraulo, S Cusmà

  • 1Istituto di Radiologia, Università degli Studi, Palermo.

La Radiologia Medica
|May 13, 1999
PubMed
Summary

Computed tomography (CT) effectively diagnoses closed loop bowel obstruction and strangulation. This imaging technique identifies key signs, aiding early surgical intervention and improving patient outcomes in critical gastrointestinal conditions.

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Area of Science:

  • Gastrointestinal Radiology
  • Abdominal Imaging
  • Surgical Gastroenterology

Background:

  • Closed loop obstruction, a severe form of bowel obstruction, carries a high risk of strangulation if not promptly treated.
  • Plain radiography has limited diagnostic value for closed loop obstruction and strangulation.
  • Computed tomography (CT) is emerging as a crucial tool for diagnosing these conditions.

Purpose of the Study:

  • To report the experience of using CT in the diagnosis of closed loop obstruction.
  • To evaluate specific CT signs indicative of closed loop obstruction and strangulation.

Main Methods:

  • Retrospective review of CT scans from 12 patients with surgically confirmed closed loop obstruction.
  • Analysis of specific CT findings: fluid-filled distended loops, C-shaped incarcerated loops, converging bowel loops and mesenteric vessels, and tapering/whirl signs at the obstruction site.

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Main Results:

  • CT successfully diagnosed closed loop obstruction in 11 out of 12 patients.
  • CT identified signs of strangulation in 3 cases, including wall thickening, vascular congestion, and mesenteric ascites.
  • One patient with a negative CT scan was diagnosed with obstruction via subsequent enteroclysis.

Conclusions:

  • CT is highly effective in identifying closed loop small bowel obstruction and associated strangulation.
  • Specific CT signs, including the whirl sign and converging mesenteric vessels, are valuable for diagnosis.
  • CT facilitates accurate preoperative evaluation, making it the preferred imaging modality for suspected strangulation.