title: Ultrasonographic differentiation of bezoar from feces in small bowel obstruction.
abstract: OBJECTIVE
  To evaluate ultrasonographic accuracy in the differentiation of a bezoar from feces in a small bowel obstruction showing feces-like material just proximal to the transitional zone in abdominal computed tomography (CT).
  
  
  METHODS
  This study included 14 patients who showed feces-like material just proximal to the transitional zone, among 302 patients diagnosed with small bowel obstruction on abdominal CT. The diagnostic signs of a bezoar on ultrasonography included an arc-like surfaced intraluminal mass, posterior acoustic shadow and twinkling artifacts. The diagnostic performance of ultrasonography in each patient was compared with a final diagnosis that was surgically or clinically made.
  
  
  RESULTS
  Among the 14 patients, seven were ultrasonographically diagnosed as having a bezoar, and five of the seven were surgically diagnosed as having a phytobezoar. The remaining two of the seven showed complete symptomatic improvement before surgery. The other seven patients were ultrasonographically diagnosed as not having a bezoar. Among them, six patients were conservatively treated with symptomatic improvement, suggesting the absence of a bezoar. The remaining one patient was confirmed not to have a bezoar during adhesiolysis. In all patients, the ultrasonographic diagnosis agreed with the clinically confirmed diagnosis.
  
  
  CONCLUSIONS
  Ultrasonography might be an accurate method for the differential diagnosis of feces-like material just proximal to the transitional zone in abdominal CT. It can help radiologists to quickly and easily diagnose a bezoar.
authors: Department of Radiology, Eulji University Hospital, Eulji University, Daejeon, Korea.
authors: Kyung Hoon
authors: 0000-0002-4818-2937
authors: KH
authors: Lee
authors: Department of Radiology, Eulji University Hospital, Eulji University, Daejeon, Korea.
authors: Hyun Young
authors: 0000-0002-9557-3957
authors: HY
authors: Han
authors: Department of Radiology, Eulji University Hospital, Eulji University, Daejeon, Korea.
authors: Hee Jin
authors: 0000-0002-6747-664X
authors: HJ
authors: Kim
authors: Department of Radiology, Eulji University Hospital, Eulji University, Daejeon, Korea.
authors: Hee Kyung
authors: 0000-0001-7400-1311
authors: HK
authors: Kim
authors: Department of Surgery, Eulji University Hospital, Eulji University, Daejeon, Korea.
authors: Moon Soo
authors: 0000-0002-3286-0385
authors: MS
authors: Lee
keywords: Bezoars; Intestinal obstruction; Intestine, small; Ultrasonography