Multidetector CT appearance of adhesion-induced small bowel obstructions: matted adhesions versus single adhesive bands

Osada, Hiroyuki; Watanabe, Wataru; Ohno, Hitoshi; Okada, Takemichi; Yanagita, Hisami; Takahashi, Tetsuya; Honda, N.

doi:10.1007/s11604-012-0121-4

Cited by 29 publications

(19 citation statements)

References 12 publications

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“…In most cases, treatment was performed with the presumptive diagnosis. However, new advances in spatial resolution, such as 64-slice MDCT and multiplanar reconstruction protocol, could improve the visualization quality of the adhesive band, especially in the patients with abundant adipose tissue [26]. Caoili et al emphasized that the detection and better delineation of the transition zone were possible in coronal reconstruction images [27].…”

Section: Discussionmentioning

confidence: 99%

The role of MDCT in the diagnosis of small bowel obstruction secondary to multiple adhesion bands: A case report

Gharekhanloo

Esnaashari

2019

ijmsci

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Adhesion band is a major cause of small bowel obstruction. Traditionally, the obtained results of computed tomography (CT) scan were indicative of adhesion band as an etiology for small bowel obstruction. However, adhesion is easily diagnosed today due to technological advances in radiology and high-quality multidetector CT. It is important to avoid the possible complications of bowel obstruction in the early and appropriate surgical intervention. This article is a report of a 45-year-old woman with abdominal pain and history of previous abdominal surgery. A contrast-enhanced CT scan showed multiple adhesion bands ensued the abrupt narrowing of bowel diameter and closed small-bowel loops obstruction. Furthermore, multiple bands were clearly observed and adhesiolysis was performed in the surgery.

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Section: Discussionmentioning

confidence: 99%

The role of MDCT in the diagnosis of small bowel obstruction secondary to multiple adhesion bands: A case report

Gharekhanloo

Esnaashari

2019

ijmsci

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“…However, in SBO with an adhesive band, APCT shows the fat notch sign, which represents extraluminal compression of the bowel by an adhesive band and can occasionally provide direct visualization of adhesive bands. 14 We diagnosed adhesive bands based on APCT findings when there was an abrupt change in bowel caliber without any other cause of obstruction, or when a transition zone associated with a dilated closed-loop appearance was observed, which is reported to be caused typically by adhesive bands. 13 , 15 The usefulness of APCT for identifying SBO with adhesive bands has been demonstrated in a previous study.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopy for Small Bowel Obstruction Caused by Single Adhesive Band

Suh

Choi

2016

JSLS

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Background and Objectives:There are still concerns about the comparative outcomes of operative treatment (OT) and conservative (nonsurgical) treatment (CT) for small bowel obstruction (SBO), especially that caused by single adhesive bands. We performed a retrospective study to compare surgical with nonsurgical outcomes.Methods:A total of 62 patients were enrolled. The OT group underwent laparoscopy (n = 16), and the CT group (n = 46) did not. We compared early and late outcomes between the 2 groups.Results:Times to first flatus, oral intake, and defecation after treatment were shorter in the OT group (P = .030, .033, and .024), and the recurrence rate was lower in the OT group than in the CT group (6.2% vs 32.6%; P = .038). Time from discharge to first recurrence was longer in the OT group than in the CT group (172 vs 104.6 ± 26.5 days, P = .027).Conclusions:SBO related to a single adhesive band is not effectively treated by CT. However, laparoscopic OT provides notable success if the surgery is performed early. Therefore, it should be the preferred treatment.

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“…In incomplete (partial or low grade) obstruction, some fluid or gas is still able to pass, whereas in complete (high grade) obstruction, no fluid or gas can pass beyond the site of obstruction. 19 Abdominal adhesions can be single-band or matted. Single-band adhesions are <1 cm long and >1 cm in diameter and cause SBO through external compression.…”

Section: Types Of Asbomentioning

confidence: 99%

“…Single-band adhesions are <1 cm long and >1 cm in diameter and cause SBO through external compression. 19,20 Bowel ischemia and high-grade obstructions are more frequent in single-band SBO. Matted adhesions are multiple, dense, and tangled, and cause SBO through intestinal kinking (sharp turn of the long axis of the bowel) or torsion (rotation of the bowel about its axis).…”

Section: Types Of Asbomentioning

confidence: 99%

Adhesive small bowel obstruction – an update

Tong

Lingam

Shelat

2020

Acute Medicine & Surgery

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Small bowel obstruction (SBO) accounts for 12–16% of emergency surgical admissions and 20% of emergency surgical procedures. Even with the advent of laparoscopic surgery, intra‐abdominal adhesions remain a significant cause of SBO, accounting for 65% of cases. History and physical examination are essential to identify signs of bowel ischemia as this indicates a need for urgent surgical exploration. Another critical aspect of evaluation includes establishing the underlying cause for obstruction and distinguishing between adhesive and non‐adhesive etiologies as adhesive SBO (ASBO) can be managed non‐operatively in 70–90% of patients. A patient with a history of abdominopelvic surgery along with one or more cardinal features of obstruction should be suspected to have ASBO until proven otherwise. Triad of severe pain, pain out of proportion to the clinical findings, and presence of an abdominal scar suggest possible closed‐loop obstruction. Computed tomography has higher sensitivity and specificity compared to plain films and is recommended by the Bologna guidelines. Correcting fluid and electrolyte imbalance is an initial crucial step to mitigate severe hypovolemia. Patients should proceed with surgery if symptoms of bowel compromise are present, or if symptoms do not resolve or have worsened. Surgery is indicated in patients with ischemia, strangulation, perforation, peritonitis, or failure of non‐operative treatment. With advances in minimal access technology and increasing experience, laparoscopic adhesiolysis is recommended. Mechanical adhesion barriers are an effective measure to prevent adhesion formation.

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Multidetector CT appearance of adhesion-induced small bowel obstructions: matted adhesions versus single adhesive bands

Cited by 29 publications

References 12 publications

The role of MDCT in the diagnosis of small bowel obstruction secondary to multiple adhesion bands: A case report

The role of MDCT in the diagnosis of small bowel obstruction secondary to multiple adhesion bands: A case report

Laparoscopy for Small Bowel Obstruction Caused by Single Adhesive Band

Adhesive small bowel obstruction – an update

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