Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction.
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.
Maglinte
D D
DD
Department of Radiology, Methodist Hosptial of Indiana, Indianapolis 46202, USA.
Reyes
B L
BL
Harmon
B H
BH
Kelvin
F M
FM
Turner
W W
WW
Hage
J E
JE
Ng
A C
AC
Chua
G T
GT
Gage
S N
SN
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
D003287:Contrast Media; D001466:Barium Sulfate