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Updated: Jun 19, 2026
Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
Computed tomography for diagnosis and risk stratification of small bowel obstruction: a systematic review and
Zhenghaoyu Huang1, Han Lin2, Mengmeng Liu3
1School of Gongli Hospital Medical Technology, University of Shanghai for Science and Technology, Shanghai, China; Department of Infectious Diseases, Gongli Hospital of Shanghai Pudong New Area, Shanghai, China.
Objectives:
To evaluate the diagnostic performance of computed tomography (CT) across clinically relevant decision points in small bowel obstruction (SBO).
Materials And Methods:
PubMed, Web of Science, Embase, and the Cochrane Library were searched from inception to January 31, 2026. Studies evaluating CT in patients with suspected or confirmed SBO were included if 2 × 2 diagnostic accuracy data were available. Study quality was assessed using QUADAS-2. Pooled sensitivity, specificity, and summary receiver operating characteristic curves were estimated using bivariate random-effects models.
Results:
Sixty-six studies involving 6,650 patients were included. For overall SBO diagnosis, CT showed pooled sensitivity of 88 % (95 % CI, 81 %-93 %) and specificity of 85 % (95 % CI, 79 %-89 %). For ischemia, pooled sensitivity and specificity were 76 % (95 % CI, 68 %-83 %) and 94 % (95 % CI, 90 %-96 %), respectively. Multiphase CT showed higher sensitivity for ischemia than single-phase CT (83 % vs. 72 %, p = 0.01), and multiplanar reconstruction improved performance. CT showed moderate accuracy for predicting surgical intervention, with sensitivity of 75 % and specificity of 81 %. Pooled sensitivity was 79 % for etiologic diagnosis and 97 % for transition-point localization.
Conclusions:
CT is reliable for confirming SBO and localizing the transition point. Its high specificity but moderate sensitivity for ischemia and moderate ability to predict surgery indicate that CT should be integrated with clinical findings.
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