Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction.

Congenital Internal Hernia a Rare Cause of Acute Intestinal Obstruction

“…At present CT has a high diagnostic accuracy not only in detecting SBO but also in defining its severity and aetiology. The later is determined by meticulous analysis of the tranisition zone between dilated and collapsed loops allowing for the correct diagnosis of the cause in 73-95 % [6,7]. The other aetiologies in the differential diagnosis of CIH include Crohn's disease, incarcerated femoral or obturator hernia, an obstructing phytobezoar, gall stone ileus and obstructing neoplasms [8].…”

Will Plain Abdominal Radiographs become Obsolete?

“…23,24 The sensitivity and specificity of abdominal radiographs in the evaluation of mechanical small-bowel obstruction is poor, with failure to confirm diagnosis in a third of cases. [25][26][27][28] Thus, in these patients, further imaging is inevitably required. 25 These often include ultrasound or CT with contrast.…”

“…CT has been shown to be superior in specificity and sensitivity compared to plain abdominal radiograph in determining the presence and cause of obstruction. 26,28 If abdominal radiography is suggestive of SBO, it is frequently followed-up with a CT scan. 27,29 Dilatation of small bowel is a common finding on plain abdominal radiograph which could suggest small bowel obstruction, paralytic ileus or intra-abdominal disorder.…”

Imaging of Ischemia, Obstruction and Infection in the Abdomen

“…It has a reported sensitivity of 69-80% for bowel obstruction [12][13][14][15] but is insensitive in assessing for complications or etiology. In addition, abdominal radiographs are neither sensitive nor specific for detection of intestinal ischemia or infectious/inflammatory conditions such as diverticulitis, colitis or appendicitis.…”