CT diagnosis of small bowel obstruction due to phytobezoar.
OBJECTIVE
Small bowel obstruction (SBO) is a commonly encountered abdominal problem in the emergency ward. Phytobezoar is an uncommon cause of SBO which has specific radiographic findings on computed tomography (CT). This study evaluated the CT appearance of small bowel phytobezoar.


METHODS
Eighty two patients with SBO who underwent CT examination and surgical treatment over a 6-year period were included. The presence of fecal ball sign, defined as a clearly distinguishable, ovoid or round intraluminal mass with mottled gas pattern outlined by fluid or oral contrast material in the dilated small bowel at the site of obstruction, and abruptly collapsed lumen beyond the lesion on CT was evaluated in all cases. The CT findings of the patients with SBO and the patients with fecal ball sign on CT were reviewed. The diagnosis was established based on surgical findings.


RESULTS
Fecal ball sign was identified in 9 of the 82 patients. Operative findings revealed that SBO was secondary to phytobezoar in 7 of these patients. The specificity and sensitivity of fecal ball sign in the diagnosis of SBO secondary to phytobezoar were 97% and 100%, respectively.


CONCLUSIONS
Fecal ball sign is accurate in the preoperative diagnosis of phytobezoar as the underlying cause of SBO. Early recognition of fecal ball sign in the CT study is of paramount importance in precise preoperative diagnosis in patients with SBO.
Liou
Chang-Hsien
CH
Department of Radiology, Tri-Service General Hospital and National Defense Medical Center, Taipei, Taiwan.
Yu
Chih-Yung
CY
Lin
Chang-Chi
CC
Chao
Yu-Chen
YC
Liou
Yao-Chi
YC
Juan
Chun-Jung
CJ
Chen
Cheng-Yu
CY
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001630:Bezoars / Q000150:complications* / Q000000981:diagnostic imaging* / Q000601:surgery; D005260:Female; D005638:Fruit; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014675:Vegetables