Improving the efficiency of diagnosis of acute bowel obstruction (ABO) using CT, also highlight indications and limitations of the method

Study included CT images of 311 patients admitted to the emergency department during Jan-Sep 2018. All patients had symptoms of acute intestinal obstruction (abdominal pain, vomiting, inability to defecate or pass gas), stable hemodynamics, had no signs of shock or/and diffuse peritonitis. The CT was performed on a 128-slice Philips Ingenuity Core tomograph with a slice thickness 1 mm. Examination with peroral iodinated contrast media administration before 6 or 12 hours, depending on the expected level of obstruction (small bowel – 4-6 hours, large bowel...

According to the CT data, among the examined patients (n = 311) admitted with the acute bowel obstruction (ABO), the large bowel obstruction was 70% (n = 218), the small bowel obstruction - 22% (n = 68). In the group of non-neoplastic ABO, mechanical bowel obstruction (adhesions, Crohn’s disease, invagination, bezoars, gallstones, foreign bodies, etc.) was 93%, dynamic obstruction (mesenteric artery disease, inflammation, metabolic disorders, neurogenic causes, toxic causes and etc.) - 7%. 90% of cases of large bowel obstruction was due to tumor stenosis....

CT is an effective method not only in diagnosing the presence of acute intestinal obstruction, but also allows for differential diagnosis of its type depending on the etiological factor, level of obstruction, degree of compensation. This is fundamental importance in the choice of treatment. The use of CT is fully justified in cases of ambiguous clinical and laboratory data and insufficient information content of other methods of medical imaging, which is of great importance given the multi-ethological nature and features of the course of ABO.

Magdebura Yu.A., MD, Radiologist in the radiology department Arablinskii A.V., MD, PhD, Professor, Head of the radiology department Parfenov I.P., MD, PhD, Professor, Head of the surgical department Moscow City Clinical Hospital named after S.P. Botkin of Moscow Health Department 125284, 2-nd Botkinsky p., 5, Moscow, Russian Federation.

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