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Published on: October 16, 2013
Can a computed tomography scoring system predict the need for surgery in small-bowel obstruction?
Kory Jones1, Alicia J Mangram, Ricardo A Lebron
1Methodist-Medical Education, 1441 North Beckley Avenue, Dallas, TX 75203, USA.
American Journal of Surgery
|November 17, 2007
Summary
A new CT scoring system accurately predicts the need for surgery in small-bowel obstruction (SBO) cases 75% of the time. Specific CT criteria, when combined, can identify patients requiring operative intervention for SBO with 79% accuracy.
Area of Science:
- Radiology
- Abdominal Surgery
- Gastroenterology
Background:
- Small-bowel obstruction (SBO) is a frequent surgical challenge.
- Accurate diagnosis of SBO relies on clinical evaluation and imaging.
- Computed tomography (CT) is a key diagnostic tool for SBO.
Purpose of the Study:
- To develop CT criteria for predicting operative intervention in SBO.
- To establish a CT scoring system for surgical decision-making in SBO.
Main Methods:
- Retrospective review of 96 SBO/PSBO patients with CT scans over 18 months.
- Independent radiologist review of CT scans, blinded to clinical outcomes.
- Development and statistical analysis of a 7-criterion CT scoring system.
Main Results:
- A CT score of 8 or higher predicted surgery need in 75% of cases.
- Complete obstruction, dilated small bowel, or free fluid on CT correlated with operative intervention.
- Specific CT criteria in combination predicted operative intervention in 79% of SBO cases.
Conclusions:
- A CT scoring system effectively predicts the need for surgery in SBO.
- Specific CT findings, when analyzed together, improve prediction of operative intervention for SBO.
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