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BACKGROUND The early postoperative context is a complex situation and CT signs are poorly studied in the literature. The objective is to evaluate the usual tomographic signs of digestive obstruction in the early postoperative period (< 21 days) of abdominal-pelvic surgery and to search for predictive factors of surgical management. METHODS We searched for adult patients who presented with digestive obstruction diagnosed by a CT scan in the early postoperative period (<21 days) of abdominal-pelvic surgery in our center over a period of 21 months. Relevant epidemiological, clinical, biological and tomographic characteristics for this pathology were collected for each patient. The new surgical management was recorded in order to search for predictive factors for surgical management by univariate and multivariate analysis. RESULTS In this study, 109 patients were recruited (aged from 20 to 92 years with a median of 63 years). The type of obstruction observed was mainly a functional digestive obstruction and secondarily a mechanical digestive obstruction due to adhesions. Some signs were frequent (62% pneumoperitoneum and 26% mesenteric edema) and others rare or absent (4% wall enhancement defect, 0% spontaneous hyperdensity of the digestive wall). 33 patients (30%) underwent surgical management. Only the aspect of digestive obstruction due to adhesions (p = 0.003) and strangulated parietal hernia (p = 0.002) were identified as predictive factors of surgical management. Other mechanisms of digestive obstruction were not predictive of surgical management in multivariate analysis. Pneumoperitoneum (p = 0.801) and mesenteric edema (p = 0.229) did not demonstrate predictability of surgical management despite their high frequency. Wall enhancement defect was not predictive of surgical management (p = 1). More specific tomographic signs of the surgical context were not predictive of surgical management (e.g., intra-abdominal drain p = 0.668). CONCLUSION CT signs of digestive obstruction in the early postoperative period of abdominal-pelvic surgery seem to be superimposable on those in the general context, except for some signs such as pneumoperitoneum, which lose their predictive value for surgical management. Only the aspect of obstruction due to adhesions and strangulated parietal hernia were found as predictive signs of surgical management