Accuracy of computed tomography in small bowel obstruction

Area of Science:

• Gastroenterology
• Radiology
• Surgical Assessment

Background:

• Small bowel obstruction is a frequent clinical issue, often caused by adhesions.
• Diagnosis typically relies on clinical signs and plain abdominal X-rays showing dilated bowel loops.
• Computed tomography (CT) is increasingly utilized to determine obstruction cause and location, guiding surgical timing.

Purpose of the Study:

• To evaluate the accuracy of CT scans in diagnosing small bowel obstruction.
• To compare CT findings with intraoperative findings in patients undergoing surgery for small bowel obstruction.

Main Methods:

• Retrospective chart review of patients diagnosed with small bowel obstruction between 2009 and 2012.
• Comparison of abdominal CT findings with surgical intervention outcomes for 60 patients.

Main Results:

• CT correctly identified small intestine involvement in 83% and colon involvement in 80% of cases.
• Adhesions and perforations were identified by CT with 21% and 50% accuracy, respectively.
• CT accurately identified transition points (64%) and masses (69%) but had low accuracy for ischemic bowel (20%).

Conclusions:

• CT plays a valuable role in assessing small bowel obstruction, accurately determining the extent of bowel involvement, masses, and transition points.
• CT's reliability is lower for identifying adhesions, perforations, and ischemic bowel, necessitating careful clinical correlation.