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Identification of adhesions on CT in small-bowel obstruction

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Abstract

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.

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Authors and Affiliations

  1. Department of Radiology, Northwestern University Feinberg School of Medicine, Suite 800, 676 N. Saint Clair Street, Chicago, IL, 60611, USA

    Bojan Petrovic, Paul Nikolaidis, Nancy A. Hammond, Thomas H. Grant & Frank H. Miller

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  1. Bojan Petrovic
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  2. Paul Nikolaidis
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  3. Nancy A. Hammond
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  4. Thomas H. Grant
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  5. Frank H. Miller
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Correspondence to Bojan Petrovic.

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An editorial comment on this paper is available at http://dx.doi.org/10.1007/s10140-005-0451-3.

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Petrovic, B., Nikolaidis, P., Hammond, N.A. et al. Identification of adhesions on CT in small-bowel obstruction. Emerg Radiol 12, 88–93 (2006). https://doi.org/10.1007/s10140-005-0450-z

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  • DOI: https://doi.org/10.1007/s10140-005-0450-z

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