Prospective evaluation of colonic obstruction with computed tomography

Background: To determine whether computed tomography (CT) can satisfactorily diagnose and evaluate patients with suspected colonic obstruction. Methods: Seventy-five patients with suspected colonic obstruction were evaluated prospectively by CT and compared with the gold standards of surgery and/or endoscopy in 65 patients, clinical course in nine, and contrast enema (CE) in one, A limited comparison between CT and CE (26) patients was also made in those patients who had both studies. Results: CT successfully diagnosed colonic obstruction in 45 of 47 patients (96% sensitivity). Pseudo-obstruction was correctly diagnosed in 26 of 28 patients (93% specificity), CT correctly localized the point of obstruction in 44 of 47 patients (94%), CE successfully diagnosed obstruction in only 20 of 25 patients (80% sensitivity). Conclusion: In this study, CT proved to be a satisfactory modality in evaluating patients with suspected colonic obstruction, CT may in certain circumstances be preferable to the traditional CE in evaluating these patients.