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Diagnostic utility of CT for small bowel obstruction: an updated systematic review and meta- analysis
Seyedeh Fatemeh Hamzavi1, Amirali Farshid2, Nima Moharamnejad2
1Alborz University of Medical Sciences, Alborz, Islamic Republic of Iran.
Background And Aims:
Small bowel obstruction (SBO) is a frequent surgical emergency in the US, responsible for 12-16% of hospital admissions for abdominal pain. While treatable with nasogastric tubes, delayed surgery for SBO with ischemia drastically increases mortality (up to 25%). This study aim to investigate the diagnostic utility of computed tomography (CT) for small bowel obstruction (SBO).
Methods:
A comprehensive search for relevant articles was conducted in PubMed, Scopus, and Google Scholar databases, encompassing studies published until February 2024. Titles, abstracts, and full texts were screened to identify eligible studies. We then assessed the quality of the included articles, extracted relevant data, and performed a rigorous analysis.
Results:
A total of 40 observational studies comprising 4,502 patients were eligible for the analysis. CT demonstrated high performance in both ruling in and ruling out SBO. The pooled sensitivity was 77.55% (95% CI: 71.41-83.69%) and specificity was 86.43% (95% CI: 82.75-90.12%), supporting its continued use for diagnosing SBO in patients with acute abdominal pain.
Conclusions:
Our findings indicate that CT offers a reliable tool for diagnosing SBO in patients with abdominal pain. CT effectively identifies key signs of SBO, facilitating informed clinical decision-making. However, observed variations in sensitivity and specificity across studies highlight the importance of using CT alongside other diagnostic modalities for a comprehensive evaluation. Additionally, the high heterogeneity among studies highlights the need for further large-scale investigations.
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