Role of multislice computed tomography in evaluation and management of intestinal obstruction

Abstract

i) to evaluate the efficacy of computed tomography (CT) imaging in diagnosing the presence, level, degree, and cause of intestinal obstruction, and the role of CT in detecting presence of complications; ii) to assess impact of CT in decision making and management (surgical/conservative); iii) to correlate CT findings with intra operative findings whenever possible. A prospective study of 40 patients presented in outpatient/emergency department with features suggestive of intestinal obstruction. Multislice contrast enhanced computed tomography of whole abdomen was done in all patients after preliminary investigations. Whenever indicated, patients were explored. Statistical analysis was performed to determine the efficacy of multidetector computed tomography (MDCT) in diagnosing intestinal obstruction and its complications. Out of 40, 30 patients underwent exploratory laparotomy and it was found that MDCT was 85% sensitive and 70% specific in diagnosing bowel obstruction. Association between MDCT findings suggestive of obstruction and intra-operative findings turn out to be significant (P=0.003). MDCT findings were consistent with intraoperative findings in 22 out of 30 patients (73%). MDCT is sensitive and specific in determining the presence of bowel obstruction and should be recommended for patients with suspected bowel obstruction because it affects outcome in these patients.

Keywords: conservative management; intestinal obstruction; laparotomy; multidetector computed tomography.

Figure 1.

Showing distribution of clinical symptoms [pain abdomen (100%), vomiting (67.5%), distension (82.5%), constipation/ obstipation (60%)].

Figure 2.

Showing distribution of clinical signs [abdominal tenderness (65%), guarding/rigidity (40%), bowel sounds (47.5%), tachycardia (80%)].