CT of small bowel obstruction in adults

Delabrousse, Éric; Destrumelle, N; Brunelle, Serge; Clair, C.; Mantion, Georges; Kastler, B.

doi:10.1007/s00261-002-0016-4

Cited by 35 publications

(28 citation statements)

References 31 publications

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“…Small-bowel obstruction (SBO) is a common surgical condition accounting for as many as 12-16% of surgical admissions annually [1][2][3][4][5][6]. Recently, it has been generally accepted that patients with an SBO should be aggressively resuscitated during a 12-to 24-h period, except when the patient is in frank septic shock [2,3,5].…”

Section: Introductionmentioning

confidence: 99%

Value of multidetector CT in decision making regarding surgery in patients with small-bowel obstruction due to adhesion

Hwang

Lee

et al. 2009

Eur Radiol

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The aim of this study was to evaluate the value of use of multidetector CT (MDCT) to predict the need for subsequent surgery in patients with small-bowel obstruction (SBO) due to adhesion. During a 3-year period, 128 patients with an SBO due to adhesion were enrolled in this prospective study. Initially, all patients were treated conservatively. Surgery was performed in patients who developed signs of strangulation or did not improve, despite a conservative treatment for at least 5 days. Of the 128 patients, 37 patients eventually underwent surgery. Two radiologists interpreted MDCT findings regarded as predictive indicators for subsequent surgery in consensus. The findings included degree of SBO, presence of transition zone, and an abnormal vascular course. These findings were statistically compared between the group operated on and the group not operated on. A higher degree of SBO, an abnormal vascular course, and the presence of transition zone were more frequently seen in the group of patients operated on (p < 0.001). Sensitivities, specificities, positive and negative predictive values, and risks for the use of MDCT to predict the need for surgery were 100%, 46.1%, 43%, 100%, and 1.9 (1.5 < or = 95% confidence interval (CI) < or = 2.2) for a high-grade obstruction; 100%, 23%, 34.5%, 100%, and 1.3 (1.2 < or = 95% CI < or = 1.5) for the presence of a transition zone; and 70.2%, 90.1%, 74.2%, 88.1%, and 7.1 (3.7 < or = 95% CI < or = 13.7) for the presence of an abnormal course of the mesenteric vessels, respectively. The presence of a high degree of SBO and an abnormal vascular course around transition zone are useful indicators on MDCT to predict the need for surgery in patients with an SBO due to adhesion.

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Section: Introductionmentioning

confidence: 99%

Value of multidetector CT in decision making regarding surgery in patients with small-bowel obstruction due to adhesion

Hwang

Lee

et al. 2009

Eur Radiol

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show abstract

“…Although water-soluble contrast studies, barium studies, ultrasonography, computed tomography (CT), and magnetic resonance imaging (MRI) may all play a role in the evaluation of SBO, some reports [38][39][40] consider CT as the most useful and powerful tool for the diagnosis of SBO. Whereas, one study 41 suggest that MRI is superior to CT in diagnosing SBO.…”

Section: Discussionmentioning

confidence: 99%