Computed tomography in the diagnosis of organic bowel obstruction.
BACKGROUND
This study examined the usefulness of computed tomography (CT) scan for cases of organic intestinal obstruction, with two simple criteria.


METHODS
One hundred and thirteen patients with clinical suspicion of bowel obstruction were referred for CT scans. A line was drawn between the dilated proximal, and the collapsed distal bowels. A careful search was conducted on this line for obstructive lesions. The results were reported to be organic obstruction if there was an abrupt change of caliber (Criterion I) or a soft tissue mass around the dilated bowel (Criterion II). The judgement based on the CT findings.


RESULTS
Eighty-eight cases proved to have bowel obstruction. With Criterion I, the sensitivity was 59.1%, and specificity, 88% with Criterion II, the sensitivity was 56.3% and specificity 100%. If either of them was considered to be a positive sign of organic obstruction, the sensitivity was 100%, the specificity 88% and the accuracy 97.3%. The nature of the obstructions were precisely predicted in 76 patients (86%).


CONCLUSIONS
With these two simple criteria, CT scan can achieve high accuracy and is a recommendation in virtually every instance when intestinal obstruction is suspected.
Department of Radiology, Veterans General Hospital-Kaohsiung, Kaohsiung, R.O.C.
H B
HB
Pan
J S
JS
Huang
C T
CT
Chen
M C
MC
Shih
K T
KT
Mok
Y Y
YY
Kan
C F
CF
Yang
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed