Learning objectives
1.
To review the imaging findings of bowel obstruction.
2.
To emphasize the role of the radiologist on their early diagnose.
3.
To describe with the CT the level of the obstruction,
the degree,
the cause and the indication of an urgent surgical treatment if required.
Background
Intestinal obstruction is a common pathology in medical emergencies.
7% of patients with abdominal pain have an obstructive condition,
constituting up to 20% of the surgical abdomens.
Intestinal obstruction is the stopping of passage of the intestinal contents at some point along the digestive tract,
secondary to a mechanical cause that prevents the progression of the intestinal contents.
We mustdifferentiate from the ileus,
that is a failure of normal intestinal motility in the absence of mechanical obstruction.
This phenomenon is common after abdominal surgery. Fig....
Findings and procedure details
CLINICAL PRESENTATION
The classic clinical features of bowel obstruction are: colicky abdominal pain,
vomiting,
abdominal distension and absolute constipation.
The order and timescale in which these appear vary depending on whether there is large or small bowel obstruction.
Absolute constipation and pain are more prominent early on in large bowel obstruction while vomiting is the predominant early feature of small bowel obstruction.
Additional features depend on the exact underlying pathology.
FIVE QUESTIONS TO ADDRESS IN SUSPECTED OBSTRUCTION
The radiologist must answer five key questions in...
Conclusion
Bowel obstruction is a serious and prevalent pathology in the emergency department,
in which the radiologist plays an important role in the diagnosis and characterization the associated findings,
as well as to determine the presence or not of complications,
which are going to be key in the planning of the surgery and the urgency of the surgery.
Personal information
Ana Belén Barba Arce
University Hospital " Marqués de Valdecilla"
Department of Radiology
Avd.
valdecilla s/n .
39008.
Santander.
Spain
References
Silva AC,
Pimenta M,
Guimarães LS.
Small bowel obstruction: what to look for.
Radiographics.
29 (2): 423-39.
Boudiaf M,
Soyer P,
Terem C et-al.
Ct evaluation of small bowel obstruction.
Radiographics.
2001;21 (3): 613-24.
Review of small-bowel obstruction: the diagnosis and when to worry.
Radiology.
2015;275 (2): 332-42.
Khurana B,
Ledbetter S,
Mctavish J et-al.
Bowel obstruction revealed by multidetector CT.
AJR Am J Roentgenol.
2002;178 (5): 1139-44.
Jaffe T,
Thompson WM.
Large-Bowel Obstruction in the Adult: Classic Radiographic and CT Findings,
Etiology,
and Mimics....