Abstract:Objective:To investigate the role of multislice spiral CT in diagnosing adhesive intestinal obstruction.
Methods :Whole abdominal multislice spiral CT scanning was performed in 35 cases of adhesive intestinal obstruction that were confirmed by operation. The CT signs were retrospectively analyzed and were evaluated in accordance with operative and pathologic results.
Results:All patients were identified to have intestinal obstruction on CT. For 31 patients with single site of obstruction, the site of obstruction was accurately identified on CT in all the pationts; for 4 patients with multiple site of obstruction, 9 of 11 obstruction sites were accurately identified on CT. Among 26 cases of non-carcinoma adhesive intestinal obstruction, 23 cases had corresponding CT signs to support the diagnosis; among 9 cases of carcinoma adhesive intestinal obstruction, 5 had direct signs of carcinoma adhesions on CT, and 2 had signs indicating the recurrence of carcinoma. The CT signs indicating intestinal strangulation were as follows: “beak sign”, “target sign”, poor or no contrast enhancement of the bowel wall, “whirl sign”, mesenteric vascular engorgement, mesenteric haziness, ascites, and “C” or “U” shaped loops. When the presentation of 2 or more signs listed above was used as the standard to diagnose the strangulated intestinal obstruction, it had a sensitivity of 93.3%, specificity of 87.5% and accuracy of 91.4%.
Conclusions:Multislice spiral CT is very useful in the diagnosis of adhesive intestinal obstruction, and is a helpful guide for the clinical management of adhesive intestinal obstruction.