title: Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction.
abstract: OBJECTIVE
  We compare the reliability and define the role of plain film radiography and CT in the assessment of various severities of small-bowel obstruction.
  
  
  METHODS
  A blinded retrospective analysis was done on 78 patients who underwent plain abdominal radiography, CT, and enteroclysis to assess for suspected small-bowel obstruction. The findings at enteroclysis and the clinical outcomes were used as standards of reference.
  
  
  RESULTS
  The sensitivity of plain film radiography for revealing small-bowel obstruction was 69% (44/64), and its specificity was 57% (8/14). Overall accuracy of plain film radiography was 67% (52/78). The sensitivity and specificity of CT were 64% (41/64) and 79% (11/ 14), respectively. Overall accuracy of CT was 67% (52/78). When obstructions were classified as low- and high-grade partial obstruction, plain film radiography and CT had sensitivities of 86% (24/28) and 82% (23/28), respectively, for high-grade obstruction and 56% (20/36) and 50% (18/36), respectively, for low-grade obstruction. CT revealed the cause of the small-bowel obstruction in 95% (39/41) of those patients in who CT correctly showed the obstruction.
  
  
  CONCLUSIONS
  Plain film radiography and CT had similar overall accuracies in showing small-bowel obstruction of various severities. Plain film radiography should remain the initial method of imaging patients with suspected small-bowel obstruction. The ability of CT to show the cause of small-bowel obstruction makes CT an important additional diagnostic tool when specific management issues must be addressed.
authors.affiliation: Department of Radiology, Methodist Hosptial of Indiana, Indianapolis 46202, USA.
authors.forename: D D
authors.initials: DD
authors.lastname: Maglinte
authors.forename: B L
authors.initials: BL
authors.lastname: Reyes
authors.forename: B H
authors.initials: BH
authors.lastname: Harmon
authors.forename: F M
authors.initials: FM
authors.lastname: Kelvin
authors.forename: W W
authors.initials: WW
authors.lastname: Turner
authors.forename: J E
authors.initials: JE
authors.lastname: Hage
authors.forename: A C
authors.initials: AC
authors.lastname: Ng
authors.forename: G T
authors.initials: GT
authors.lastname: Chua
authors.forename: S N
authors.initials: SN
authors.lastname: Gage
mesh_terms: D000328:Adult; D000368:Aged; D001466:Barium Sulfate; D003287:Contrast Media; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging*; D007421:Intestine, Small / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D001466:Barium Sulfate