Ces radiol. 2008, 62(1):66-73

The role of CT-enterography in imaging of small bowel obstructionOriginal article

Jan Baxa1, Jiří Ferda1, Petr Novák2, Jiří Moláček2, Hynek Mírka1, Alena Bednářová1, Jana Koželuhova3, Vladislav Třeška2, Boris Kreuzberg1
1 Radiodiagnostická klinika FN a LF UK, Plzeň
2 Chirurgická klinika FN a LF UK, Plzeň
3 I. interní klinika FN a LF UK, Plzeň

Aim: To evaluate capabilites of imaging in small bowel obstruction (SBO) using CT-enterography with oral application of the osmotic active 2.5% solution of mannitol and to evaluate its value in therapeutic strategy decisions.

Method: Within years 2005 and 2007, a total of 358 CT-enterography procedures was perforemed. Among these, 51 cases showed signs of small bowel obstruction and were retrospectively evaluated. Findings were compared with patients' history and subsequent therapy. 24 (47%) of all selected 51 patients (32 females, 19 males, mean age 49.3 y, range 10-81 years) underwent surgery. Bowel distension was quantified in all subjects with obstruction.

Results: Crohn disease was detected in 31 subjects (60.8%) as a cause of SBO, abdominal adhesions in 14 subjects (27.5%), tumor infiltration in 2 subjects (3.9%), internal hernia, umbilical hernia, infectious enteritis, and biliary ileus were found in one subject each (2.0%). Surgery proved the imaging findings in all subjects who underwent operation. Average pre-stenotic small bowel dilatation yielded 36.6 mm; pre-stenotic dilatation was significantly greater in patiens who were treated by surgery (39.4 mm) than in patiens treated conservatively (33.8 mm).

Conclusion: Our results show that CT-enterography is feasible and simple method for diagnostics of SBO. If the diameter of small bowel is more than 30 mm on CT-enterography, pre-stenotic dilatation is very likely; diameter of more than 35 mm predicts high probability of surgerical treatment.

Keywords: CT-enterography, computer tomography, small bowel obstruction, pre-stenotic dilatation
Grants and funding:

Práce byla podpořena výzkumným záměrem MSM 0021620819.

Accepted: January 3, 2008; Published: March 1, 2008  Show citation

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Baxa J, Ferda J, Novák P, Moláček J, Mírka H, Bednářová A, et al.. The role of CT-enterography in imaging of small bowel obstruction. Ces radiol. 2008;62(1):66-73.
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