[Significant findings on CT performed before presence of post-surgical bowel obstruction]

We evaluated whether CT performed before the presence of bowel obstruction (pre-CT) is useful in predicting the presence of post-surgical bowel obstruction. Thirty-three patients with post-surgical bowel obstructions who had pre-CT were reviewed. The pre-CT findings were compared with the findings of CT performed after the presence of bowel obstruction (post-CT) in 16 patients, and with the intraoperative findings in 18 patients. Pre-CT demonstrated many interesting findings, such as a discrepancy in the caliber of the bowel, the presence of two adjacent collapsed loops, a beak-like appearance of the bowel, focal distention and/or wall thickness of bowel loops, and twisted mesentery. Twenty-three (70%) of 33 patients had one or more of these findings on pre-CT. All patients with a surgically proved closed loop obstruction had two adjacent collapsed loops on both pre- and post-CT. In six (86%) of seven patients who had focal dilated bowel loops and twelve (71%) of seventeen patients who had twisted mesentery on pre-CT, conservative management was proved ineffective. Pre-CT showed many significant findings. Attention should be paid to these findings, because they can predict the presence of post-surgical bowel obstruction. In particular, we stress that two adjacent collapsed loops on pre-CT is a sign of the presence of post-surgical closed loop obstruction.