title: Identification of adhesions on CT in small-bowel obstruction.
abstract: Identification of adhesions on computed tomography (CT) in cases of small-bowel obstruction (SBO) is currently a diagnosis of exclusion. The purpose of this study is to examine whether the presence of findings suggestive of an extraluminal band can be used as a CT sign for adhesive SBO. CT scans of 142 patients with surgically proven SBO performed within 72 h of exploratory surgery were reviewed. The studies were evaluated for the cause of SBO and the presence of extraluminal bands. An extraluminal band was considered present if there was a change in the conformation of the transition zone, suggesting extraluminal compression of the bowel by a linear obstructive band. The presence of extraluminal bands in the area of the transition zone had a high positive predictive value for adhesive SBO. Of the 73 cases in which bands were present, SBO was due to adhesions in 52 instances, with a corresponding positive predictive value of 71% (95% confidence interval 0.60-0.80) and a p value of 0.008. The extraluminal band was 61% sensitive and 63% specific for adhesive SBO. The presence of an extraluminal band on CT in the area of the transition zone in cases of SBO correlates well with a diagnosis of SBO secondary to adhesions. In the absence of a source of SBO, the presence of an extraluminal band can serve as a helpful diagnostic adjunct for adhesive SBO.
authors.affiliation: Department of Radiology, Northwestern University Feinberg School of Medicine, Suite 800, 676 N. Saint Clair Street, Chicago, IL 60611, USA. b-petrovic@northwestern.edu
authors.forename: Bojan
authors.initials: B
authors.lastname: Petrovic
authors.forename: Paul
authors.initials: P
authors.lastname: Nikolaidis
authors.forename: Nancy A
authors.initials: NA
authors.lastname: Hammond
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Grant
authors.forename: Frank H
authors.initials: FH
authors.lastname: Miller
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D007415:Intestinal Obstruction / Q000000981:diagnostic imaging*; D007421:Intestine, Small; D008297:Male; D008875:Middle Aged; D011860:Radiography, Abdominal; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000000981:diagnostic imaging*; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media