Small-bowel bezoar versus small-bowel feces: CT evaluation.

Area of Science:

• Gastroenterology
• Radiology
• Abdominal Imaging

Background:

• Small-bowel obstruction (SBO) is a common surgical emergency.
• Differentiating bezoars from fecal impaction in the small bowel can be challenging.
• Accurate diagnosis is crucial for appropriate management and patient outcomes.

Purpose of the Study:

• To evaluate the diagnostic accuracy of computed tomography (CT) in distinguishing small-bowel bezoars from small-bowel feces.
• To identify specific CT features that aid in differentiating these two common causes of SBO.

Main Methods:

• Retrospective analysis of CT scans from patients diagnosed with SBO.
• Comparison of CT findings with surgical or pathological diagnoses.
• Evaluation of specific CT characteristics such as mass morphology, presence of gas bubbles, and associated findings.

Main Results:

• CT demonstrated varying accuracy in differentiating bezoars from feces.
• Overlapping CT features were observed between bezoars and fecal impaction.
• Specific signs like a well-defined mass with an encapsulating wall and "floating fat-density debris" were more indicative of bezoars.

Conclusions:

• CT can differentiate small-bowel bezoars from small-bowel feces in SBO, though some features overlap.
• A well-defined mass with gas bubbles, an encapsulating wall, "floating fat-density debris," and a similar gastric lesion suggest a bezoar.
• An isolated amorphous mass with gas bubbles is more typical of small-bowel feces.