Keywords:
CT-Enterography, CT, Small bowel, Emergency, Abdomen, CT-Angiography, Contrast agent-oral, Contrast agent-intravenous, Acute, Obstruction / Occlusion
Authors:
Y. A. Magdebura, A. Arablinskiy, I. P. Parfenov; Moscow/RU
DOI:
10.26044/ecr2019/C-1927
Results
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.
In 8% of cases (n = 25) from all examined patients they were no CT signs of pathology.
In the overwhelming majority of this cases,
the main reason was resolution of obstruction during the preparatory period (the effect of conservative therapy,
the therapeutic effect of the contrast agent).
(Fig.1) When analyzing images obtained with CT,
we searched not only for signs of directly intestinal obstruction,
but also the reasons for the development of this state (tumor,
foreign body,
specific changes in the wall and configuration of the intestine,
surrounding tissues,
etc.) (Fig.1-8) All CT findings were compared with the final diagnosis recorded in the patient's medical card.
Thus,
the sensitivity of CT was 97%,
specificity - 93.5%,
p> 0.05.
A predictive value of a positive result is 99.6%,
a predictive value of a negative result is 68%.