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[Mechanical small bowel obstruction due to bezoars: correlation between CT and surgical findings]
Y Billaud1, F Pilleul, P J Valette
1Service d'Imagerie Médicale, Hôpital d'Instruction des Armées Desgenettes, Lyon, France.
Purpose:
To evaluate the correlation between computed tomography (CT) and surgery, for the diagnosis of bezoar in small bowel obstruction. To analyze the predisposing etiologic factors in this population.
Patients And Methods:
We reviewed retrospectively between 1994 and 1999, 12 patients whose final diagnosis was small bowel obstruction with bezoar. All patients underwent helical CT scan before treatment. Eight patients were treated by surgery and 4 recovered with gastric aspiration.
Results:
Small bowel obstruction was diagnosed by CT which always demonstrated a transition zone with ovoid intraluminal mass outlined by the bowel wall. The mass consisted of a mixture of soft tissue and internal gas bubbles like feces, suggesting bezoar. Surgery confirmed small bowel obstruction and presence of bezoar. Predisposing factors were: partial gastrectomy (2/12), post surgical adhesions (7/12), Meckel diverticulum (1/12) and dietary factors.
Conclusion:
We agree with the authors of the few prior CT reports and suggest that the characteristic CT appearance of mottled gas pattern is pathognomonic of bezoar with an excellent correlation in our population.