Obstruction of the small intestine: accuracy and role of CT in diagnosis.

Abstract

The reliability of abdominal computed tomography (CT) in the assessment of varying degrees of small bowel obstruction (SBO) was evaluated by using results at enteroclysis and clinical outcome as standards of reference. A blinded retrospective analysis was performed of the studies of 55 patients who underwent both CT and enteroclysis in the course of assessment for suspected SBO. Nine patients had no obstruction, 40 patients had obstruction due to adhesions, and six patients had tumor-related obstruction. CT results were used to identify correctly 63% (29 of 46) of those who had SBO and 78% (seven of nine) of the patients who did not. The overall accuracy of the CT interpretations to help establish diagnosis was 65% (36 of 55). When obstructions were classified into low- and high-grade partial obstruction, CT results could be used to identify correctly 81% (17 of 21) of high-grade SBOs and 48% (12 of 25) of low-grade SBOs. The procedure yielded two false-positive and 13 false-negative results for patients with low-grade obstruction, revealed masses in all six cases with tumor-related obstruction, and helped predict the correct cause in all true-positive cases.

Hernia obturatriz y obstrucción intestinal. Reporte de caso

“…En nuestro caso, la radiografía de abdomen no mostró signos de obstrucción. Cabe agregar que la radiografía simple de abdomen tiene una sensibilidad del 69 % y una especificidad del 57 % para diagnóstico de obstrucción intestinal 9 .…”

İnce Barsak Hastalıklarında Enteroklizis’in Tanı Değeri

“…Peristaltik aktivite yokluğu nedeniyle, ileri dönem obstrüksiyonlarda, baryumun lezyon seviyesine ulaşması da uzun sürmektedir. Bu tür obstrük-siyonlarda söz konusu olabilecek gangren kuşkusunda baryum kontrendike olduğundan tanıda BT'den yararlanıl-maktadır (21,22).…”

Early diagnosis of bowel obstruction and strangulation by computed tomography in emergency department

“…Use of PAR in evaluation of patients with clinically suspected SBO has a sensitivity of 69% and a specificity of 57%. [8] Other studies have also reported a sensitivity of 63%-77% and a specificity of 50%-78%. [9,10] A recent study [11] of patients with abdominal pain treated at an emergency department revealed a sensitivity of 82% and a specifi city of 96.4% in plain abdominal radiography for small bowel obstruction.…”

“…Several studies [8,[12][13][14][15][16][17][18] have demonstrated the accuracy of CT in confirming the diagnosis and also revealing the site, level and cause of SBO, with a sensitivity of 94%-100% and a specificity of 90%-95%. A review of the literature also supported the use of CT as a sensitive and specifi c test for SBO.…”