Computed Tomography in the Assessment of Suspected Large Bowel Obstruction

Beattie, G. C.; Peters, Robert Thomas; Guy, Susanne; Mendelson, Richard

doi:10.1111/j.1445-2197.2006.03998.x

Cited by 59 publications

(27 citation statements)

References 12 publications

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“…CT has replaced contrast enema in the investigation of acute large bowel obstruction and has become a standard and acceptable baseline modality to both diagnose and characterise patients with symptoms suggestive of obstruction [13]. With increasing familiarity with the technique, CT imaging's sensitivity for large bowel obstruction has surpassed that of contrast enema [14, 15]. …”

Section: Discussionmentioning

confidence: 99%

Large Bowel Obstruction, a Delayed Complication of Severe Gallstone Pancreatitis

Lal

Whiting

Hejmadi

et al. 2016

Case Reports in Surgery

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Colonic complications are rare after acute pancreatitis but are associated with a high mortality. Possible complications include mechanical obstruction, ischaemic necrosis, haemorrhage, and fistula. We report a case of large bowel obstruction in a 31-year-old postpartum female, secondary to severe gallstone pancreatitis. The patient required emergency laparotomy and segmental bowel resection, as well as cholecystectomy. Presentation of obstruction occurs during the acute episode or can be delayed for several weeks. The most common site is the splenic flexure owing to its proximity to the pancreas. Initial management may be conservative, stenting, or surgical. CT is an acceptable baseline investigation in all cases of new onset bowel obstruction. Although bowel obstruction is a rare complication of pancreatitis, clinicians should be aware of it due to its high mortality. Obstruction can occur after a significant delay following the resolution of pancreatitis. Those patients with evidence of colonic involvement on pancreatic imaging warrant further large bowel evaluation. Bowel resection may be required electively or acutely. Colonic stenting has an increasing role in the management of large bowel obstruction but is a modality of treatment that needs further evaluation in this setting.

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Section: Discussionmentioning

confidence: 99%

Large Bowel Obstruction, a Delayed Complication of Severe Gallstone Pancreatitis

Lal

Whiting

Hejmadi

et al. 2016

Case Reports in Surgery

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“…Recent studies have demonstrated the superiority of CT in revealing the site, level, and cause of intestinal obstructions and in demonstrating threatening signs of bowel nonviability [9,10] . As was shown in our study, the majority of AIs presented with partial or complete intestinal obstruction.…”

Section: Figure 3 Efferent Loop Intussusception With a Tubementioning

confidence: 99%

Adult intussusception: A retrospective review of 41 cases

Wang

Cui²,

Liu³

et al. 2009

WJG

220

263

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AIM:To optimize the preoperative diagnosis and surgical management of adult intussusception (AI). METHODS:A retrospective review of the clinical features, diagnosis, management and pathology 41 adult patients with postoperative diagnoses of intussusception was conducted. RESULTS:Forty-one patients with 44 intussusceptions were operated on, 24.4% had acute symptoms, 24.4% had subacute symptoms, and 51.2% had chronic symptoms. 70.7% of the patients presented with intestinal obstruction. There were 20 enteric, 15 ileocolic, eight colocolonic and one sigmoidorectal i n t u s s u s c e p t i o n s . 6 5 . 9 % o f i n t u s s u s c e p t i o n s were diagnosed preoperatively using a computed tomography (CT ) scan (90.5% accurate) and ultrasonography (60.0% accurate, rising to 91.7% for patients who had a palpable abdominal mass). Coloscopy located the occupying lesions of the lead point of ileocolic, colocolonic and sigmoidorectal intussusceptions. Four intussusceptions in three patients were simply reduced. Twenty-one patients underwent resection after primary reduction. There was no mortality and anastomosis leakage perioperatively. Except for one patient with multiple small bowel adenomas, which recurred 5 mo after surgery, no patients were recurrent within 6 mo.Pathologically, 54.5% of the intussusceptions had a tumor, of which 27.3% were malignant. 9.1% comprised nontumorous polyps. Four intussusceptions had a gastrojejunostomy with intestinal intubation, and four intussusceptions had no organic lesion. CONCLUSION:CT is the most effective and accurate diagnostic technique. Colonoscopy can detect most lead point lesions of non-enteric intussusceptions. Intestinal intubation should be avoided.

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“…The condition makes the cecum dependent on parietal infusions, and regions of fragility appear due to the precariousness of vascular anastomoses [5]. This hastens progression to bowel perforation, generating fecal peritonitis and considerably increasing the risk of morbidity and mortality in such cases [6].…”

Section: Introductionmentioning

confidence: 99%

“…CT is considered the gold standard for diagnosis. According to Beattie et al, the large intestine is considered dilated when greater than 6 cm, except for the cecum where the limit is 9 cm [6].…”

Section: Introductionmentioning

confidence: 99%

Perforation of the cecum resulting from a closed-loop obstruction in a patient with an adenocarcinoma of the sigmoid colon: a case report

Toledo

Correia

Coutinho

et al. 2017

International Journal of Surgery Case Reports

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HighlightsBowel obstruction is one of the principal non-traumatic causes of general surgery emergencies, both in Brazil and worldwide.The progression of bowel obstruction, particularly when the ileocecal valve is competent, may result in excessive dilatation of the cecum.A syndromic diagnosis of bowel obstruction was made, and the patient was referred for CT.The estimates of the Brazilian National Cancer Institute (INCA) for this country in 2016 were around 16,660 new cases in men and 17,620 in women.Colorectal cancer is one of the most common forms of cancer in the elderly, perforation of the cecum occurs in only around 3–8% of cases.

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Computed Tomography in the Assessment of Suspected Large Bowel Obstruction

Abstract: Computed tomography with additional selective prone and/or decubitus scanning is highly effective in the diagnosis of mechanical LBO. It is suggested that it replace contrast enema as the initial imaging method.

Cited by 59 publications

References 12 publications

Large Bowel Obstruction, a Delayed Complication of Severe Gallstone Pancreatitis

Large Bowel Obstruction, a Delayed Complication of Severe Gallstone Pancreatitis

Adult intussusception: A retrospective review of 41 cases

Perforation of the cecum resulting from a closed-loop obstruction in a patient with an adenocarcinoma of the sigmoid colon: a case report

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