Utility of 64-row multidetector computed tomography in diagnosis and management of small bowel obstruction

Purpose

The goal of the study was to assess and confirm the role of 64-slice multidetector computed tomography (MDCT) with its new applications for diagnosis and its impact on management of small bowel obstruction.

Patients and methods

Prospective study included 40 patients, referred for radiological assessment of one or more of symptoms of intestinal obstruction or acute abdomen. Patients with clinical suspicion of high grade SBO (30 patients) underwent MDCT, while those with low grade SBO (10 patients) were offered MDCT enterography and the results were compared to the final clinical and surgical diagnosis as well as the histopathology results.

Results

18 patients were found to have intrinsic cause of SBO. 17 patients found to have extrinsic cause of SBO including adhesions and different types of hernia. 1 patient with an intraluminal cause (gall stone ileus) and 4 patients with variety of causes involving ileus, midgut volvulus and Ladd's band compressing duodenum. Those results were compared to final clinical surgical diagnosis with 100% accuracy, sensitivity and specificity.

Conclusion

64-slice MDCT have a very high sensitivity, specificity and accuracy to diagnose and determine the cause of SBO, allowing for better planning of required surgeries.