Identification of adhesions on CT in small-bowel obstruction

被引：57

作者：

Petrovic B. ^{[1
]}

Nikolaidis P. ^{[1
]}

Hammond N.A. ^{[1
]}

Grant T.H. ^{[1
]}

Miller F.H. ^{[1
]}

机构：

[1] Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611

来源：

Emergency Radiology | 2006年 / 12卷 / 3期

关键词：

Adhesions; Band; Bowel obstruction; Computed tomography; CT; Intestinal obstruction;

D O I：

10.1007/s10140-005-0450-z

中图分类号：

学科分类号：

摘要：

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. © Am Soc Emergency Radiol 2005.

引用

页码：88 / 93

页数：5

共 22 条

[1]

Suh R.S., Maglinte D.D.T., Lavonas E.J., Et al., Emergency abdominal radiography: Discrepancies of preliminary and final interpretation and management relevance, Emerg Radiol, 2, pp. 1-4, (1995)

[2]

McFadden D.W., Zinner M.J., Manifestations of gastrointestinal disease, Principles of Surgery, pp. 1015-1042, (1994)

[3]

Megibow A.J., Balthazar E.J., Cho K.C., Et al., Bowel obstruction: Evaluation with CT, Radiology, 180, pp. 313-318, (1991)

[4]

Fukuya T., Hawes D.R., Lu C.C., Et al., CT diagnosis of small-bowel obstruction: Efficacy in 60 patients, AJR Am J Roentgenol, 158, pp. 765-769, (1992)

[5]

Furukawa A., Yamasaki M., Furuichi K., Et al., Helical CT in the diagnosis of small bowel obstruction, Radiographics, 21, pp. 341-355, (2001)

[6]

Maglinte D.T., Reyes B.L., Harmon B.H., Et al., Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction, AJR Am J Roentgenol, 167, pp. 1451-1455, (1996)

[7]

Frager D.H., Baer J.W., Role of CT in evaluating patients with small-bowel obstruction, Semin Ultrasound CT MR, 16, pp. 127-140, (1995)

[8]

Hulnick D.H., Small intestine, Computed Tomography of the Gastrointestinal Tract, (1986)

[9]

Balthazar E.J., George W. Holms Lecture. CT of small-bowel obstruction, AJR Am J Roentgenol, 162, pp. 255-261, (1994)

[10]

Bizer L.S., Liebling R.W., Delany H.M., Et al., Small bowel obstruction: The role of non-operative treatment in simple intestinal obstruction and predictive criteria for strangulation obstruction, Surgery, 89, pp. 407-413, (1981)

← 1 2 3 →