Bowel obstruction: evaluation with CT.
Eighty-four computed tomographic (CT) scans from patients referred for bowel obstruction between January 2, 1988, and December 31, 1989, were retrospectively evaluated. A pair of radiologists without knowledge of patient histories determined the presence or absence of bowel obstruction. Sixty-four patients ultimately proved to have intestinal obstruction, and 20 did not. Diagnosis was established by means of surgery (n = 39), barium studies (n = 17), and clinical course (n = 28). Causes of obstruction included adhesions (n = 37), metastases (n = 6), primary tumor (n = 7), Crohn disease (n = 4), hernia (n = 3), hematoma (n = 2), colonic diverticulitis (n = 2), and other (n = 3). In addition, 83 CT examinations in patients with no history or indication of intestinal obstruction were simultaneously reviewed. The overall sensitivity was 94%, specificity was 96%, and accuracy was 95%. The cause of obstruction was correctly predicted in 47 of 64 cases (73%). Intestinal obstruction was not diagnosed in any of the 83 control patients. CT is most useful in patients with a history of abdominal malignancy and in patients who have not been operated on and who have signs of infection, bowel infarction, or a palpable abdominal mass.
Megibow
A J
AJ
Department of Radiology, New York University Medical Center, NY 10016.
Balthazar
E J
EJ
Cho
K C
KC
Medwid
S W
SW
Birnbaum
B A
BA
Noz
M E
ME
D001466:Barium Sulfate; D003108:Colonic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology; D003287:Contrast Media / Q000008:administration & dosage; D005069:Evaluation Studies as Topic; D006801:Humans; D007410:Intestinal Diseases / Q000150:complications / Q000000981:diagnostic imaging; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity; D000267:Tissue Adhesions / Q000150:complications / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed / Q000379:methods
D003287:Contrast Media; D001466:Barium Sulfate