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Prospective evaluation of colonic obstruction with computed tomography
D Frager1, H D Rovno, J W Baer
1Columbia University College of Physicians and Surgeons, St. Luke's/Roosevelt Hospital Center, Department of Radiology, New York, NY 10019, USA.
Background:
To determine whether computed tomography (CT) can satisfactorily diagnose and evaluate patients with suspected colonic obstruction.
Methods:
Seventy-five patients with suspected colonic obstruction were evaluated prospectively by CT and compared with the gold standards of surgery and/or endoscopy in 65 patients, clinical course in nine, and contrast enema (CE) in one. A limited comparison between CT and CE (26) patients was also made in those patients who had both studies.
Results:
CT successfully diagnosed colonic obstruction in 45 of 47 patients (96% sensitivity). Pseudo-obstruction was correctly diagnosed in 26 of 28 patients (93% specificity). CT correctly localized the point of obstruction in 44 of 47 patients (94%). CE successfully diagnosed obstruction in only 20 of 25 patients (80% sensitivity).
Conclusion:
In this study, CT proved to be a satisfactory modality in evaluating patients with suspected colonic obstruction. CT may in certain circumstances be preferable to the traditional CE in evaluating these patients.
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