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Computed tomography compared with small bowel enema in clinically equivocal intestinal obstruction
1Department of Radiology, College of Medicine and King Khalid University Hospital, King Saud University, Riyadh, Kingdom of Saudi Arabia.
Clinical Radiology
|April 7, 1998
Summary
Computed tomography (CT) and small bowel enema (SBE) have limitations in diagnosing small bowel obstruction. While SBE accurately identifies obstruction, CT excels at determining its cause and detecting strangulation, especially in complex cases.
Area of Science:
- Radiology
- Gastroenterology
- Abdominal Imaging
Background:
- Small bowel obstruction (SBO) diagnosis can be challenging.
- Computed tomography (CT) and small bowel enema (SBE) are diagnostic modalities for SBO.
- Clinical presentation of SBO can be equivocal, necessitating accurate imaging.
Purpose of the Study:
- To compare the diagnostic accuracy of CT and SBE for small bowel obstruction.
- To identify limitations of CT in evaluating SBO.
- To determine the reasons for CT's limitations in SBO diagnosis.
Main Methods:
- A 5-year retrospective analysis of 49 patients with SBO who underwent both CT and SBE.
- Categorization of SBE findings into partial low-grade, partial high-grade, and complete obstruction.
- Comparison of CT findings with SBE results and critical analysis of CT false-negative cases.
Main Results:
- CT correctly identified 34 out of 43 proven SBO cases, with higher accuracy for high-grade obstructions.
- CT sensitivity, specificity, and positive predictive value were 83%, 67%, and 94%, respectively.
- CT demonstrated superiority in identifying extraluminal masses, abscesses, malignancy, and strangulation features.
Conclusions:
- SBE is more accurate for detecting the presence and location of SBO.
- CT is superior for determining the cause of SBO and identifying strangulation.
- In CT-negative equivocal cases, SBE may be a valuable adjunct to CT imaging.