J Korean Radiol Soc.  1994 May;30(5):875-880.

CT Diagnosis of Intestinal Obstruction: Findings and Usefulness

• Kim MY
• Park CS
• Kim KR
• Shin YW
• Oh ST
• Suh CH
• Chung WK
• Cho SG
• Chung WJ
• Yoh KT
• Ok CS

Abstract

PURPOSE
To present the findings of intestinal obstruction and evaluate the value of CT in the diagnosis of intestinal obstruction.
MATERIALS AND METHODS
We prospectively analyzed CT scans of twenty-two patients who were suspected to have intestinal obstruction. All 22 patients were confirmed with surgery:10 patients with adhesion, four with primary intestinal tumor, one with metastatic intestinal tumor, two with inflammatory bowel disease, two with intussusception, two with extrinsic compression by ovarian tumor, and one with inguinal hernia. The CT scans were evaluated with special attention to their causes, locations, and CT findings of intestinal obstruction. CT diagnosis and findings were compared with surgical results.
RESULTS
Their causes were diagnosed correctly on CT scans in seventeen of 22 cases(77.3%). Locations of the intestinal obstruction were diagnosed correctly in 16 cases(72.7% ). The CT findings of intestinal obstruction were categorized into dilated proximal bowel loops with normal distal loops, thickening of the affected bowel wall, presence of the transitional zone, and no detectable abnormalities. The associated extraluminal findings were fat infiltration around the dilated bowel loops, ascites, and mesenteric lymphnodes enlargement. There were two limitations of CT in our study:first, no detectable differences between jejunum and ileum on CT scans, and second, difficulty in differential diagnosis between thickened bowel wall mimicking normal non-dilated segment and mechanical obstruction from tumors or inflammatory bowel diseases.
CONCLUSION
We conclude that CT is useful method in the evaluation of causes and locations of intestinal obstruction and the demonstration of the associated extraluminal abnormalities.

MeSH Terms

Ascites
Diagnosis*
Diagnosis, Differential
Hernia, Inguinal
Humans
Ileum
Inflammatory Bowel Diseases
Intestinal Obstruction*
Intussusception
Jejunum
Prospective Studies
Tomography, X-Ray Computed