Value of CT in the diagnosis of mechanical intestinal obstruction

Objective To evaluate the role of CT in the diagnosis of patients with suspected intestinal obstruction in whom clinical and/or plain radiographic findings were inconclusive. Methods The plane and contrast enhanced CT manifestation and surgical findings or clinical follow up in 52 cases with mechanical intestinal obstruction were retrospectively analyzed. Results CT manifestation and surgical findings were consistent in 48 (92%) of 52 cases,including primary or secondary neoplasms (12), adhesions (10), intussusception (9, including 5 cases of neoplasms),bowel torsion (5), external or internal hernias (5), gallstone ileus (3),appendicitis (2), Crohn′s disease (1), and colon ulcer (1). Neoplasms and adhesions was misdiagnosed in 2 cases each.A CT diagnosis of ischemia was made in 4 of 5 patients,the most frequent CT findings were reduced enhancement of the bowel wall and thickening of the bowel wall. Conclusion CT can help differentiate mechanical obstruction from other conditions resulting in bowel dilatation,determine the location and cause of obstruction rapidly, and reveal the evidence of strangulation.These make CT particularly valuable in the management of intestinal obstruction.