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The CT small bowel faeces sign: description and clinical significance
W W Mayo-Smith1, J Wittenberg, G L Bennett
1Department of Radiology, Massachusetts General Hospital, Boston, USA.
Objective:
To describe a new CT sign of the GI tract: the small bowel faeces sign, and discuss its significance.
Methods:
The small bowel faeces sign consists of gas bubbles mixed with particulate matter in dilated segments of small bowel. This was a retrospective study of 22 patients demonstrating this sign from 1989 to 1993. Final diagnosis was established by surgical, medical or laboratory findings. To determine the prevalence of the sign, the CT examination of 120 consecutive separate control patients were evaluated.
Results:
All 22 of the patients demonstrating this sign required hospitalization with surgical or medical intervention. Eighteen of 22 had mechanical small bowel obstruction. The remaining four patients had other abnormalities of small bowel to account for the finding on CT. Twelve of the 22 patients were treated with surgery and the remaining 10 patients were treated with nasogastric tubes (n = 6) or other medical therapy (n = 4). None of the 120 control patients demonstrated the sign.
Conclusion:
The presence of gas and particulate material resembling faeces in a dilated segment of small bowel on CT is abnormal. Most (18/22; 82%) patients with this sign had small bowel obstruction.