Published: 2019-03-27

Clinical study on role of CECT abdomen in intestinal obstruction

Bhavesh V. Vaishnani, Mohammad Farooque G. Dudhwala


Background: Intestinal obstruction is a common clinical occurrence and can be either dynamic or adynamic. The old saying “Never let the sun set or rise on an obstructed bowel” taught to minimize missing strangulation. Helical CT with its multiplanar reformatted imaging can accurately characterize the level, degree, cause and associated complications of obstruction. Aim of the study was to depict the spectrum of MDCT findings in cases of small and large bowel obstruction and correlation of CT scan with intraoperative findings and the cause of intestinal obstruction.

Methods: Contrast enhanced MDCT examination of 50 patients were prospectively included in the study who had evidence of clinical as well as MDCT evidence of bowel obstruction and in whom surgical/clinical follow-up for final diagnosis was available. CT scan was done in all the patients with MDCT (Brightspeed GE 16 slice system). The axial sections were reconstructed in coronal and saggital planes to determine site and cause of bowel obstruction.

Results: The commonest cause of intestinal obstruction in adults in this study series was adhesions/bands in 38% cases. Out of 47 operated patients for intestinal obstruction, CT findings matched with intraoperative findings in 43 patients (91%) whereas cause of intestinal obstruction matched with CT findings in 37 patients (74%).

Conclusions: Management decisions in intestinal obstruction remain notoriously difficult, relying on a combination of clinical, laboratory, and imaging factors to help stratify patients into conservative or surgical treatment. CT in these patients can help surgeon to go for surgery early and prevent complications.


Acute abdomen, Adhesions, CT scan, Constipation, Laparotomy, Obstruction

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Miller G, Boman J, Shrier I, Gordon PH. Natural history of patients with adhesive small bowel obstruction. Br J Surg. 2000;87:1240.

Wright HK, O' Brien JJ, Tilson MD. Water absorption in experimental closed segment obstruction of the ileum in man. Am J Surg. 1971;121:96.

Ray NF, Denton WG, Thamer M. Abdominal adhesiolysis: inpatient care and expenditures in the United States in 1994. J Am Coll Surg. 1998;186:1.

Butt MU, Velmahos GC, Zacharias N. Adhesional small bowel obstruction in the absence of previous operations: management and outcomes. World J Surg. 2009;33:2368.

Maglinte DD, Gage SN, Harmon BH, Kelvin FM, Hage JP, Chua GT, et al. Obstruction of the small intestine: accuracy and role of CT in diagnosis. Radiol. 1993;188:61-4.

Frager D, Medwid SW, Baer JW, Mollinelli B, Friedman M. CT of small-bowel obstruction: value in establishing the diagnosis and determining the degree and cause.AJR Am J Roentgenol. 1994;162:37-41.

Adhikari S, Hossein M, Das A, Mitra N, Ray U. Etiology and outcome of acute intestinal obstruction: A review of 367 patients in Eastern India. Saudi J Gastroenterol. 2010;16(4):285.

Cole G. A review of 436 cases of intestinal obstruction in Ibadan. Gut. 1965;6(2):151-62.

Harban Singh. Acute intestinal obstruction. Arch Surg. 1965;91:389-92.

Gill SS, Eggleston FC. Acute Intestinal Obstruction. Arch Surg. 1965;91:389-92.

Ramachandran CS. Acute intestinal obstruction: 15 years experience. IJS. 1982;672-9.

Budharaja SN, Govindarajalu S, Perianayagum WJ. Acute intestinal obstruction in Pondicherry. IJS. 1976;38:3-11.

Shakeed S, Matsumoto T. Intestinal obstruction. Am J Surg. 1975;130(1):9-14.

Khan JS, Alam J, Hassan H, Iqbal M. Pattern of intestinal obstruction a hospital based study. Pakistan Armed Forces Medical J. 2007 Dec 31;57(4):295-9.

Playforth R, Holloway J, Griffen W. Mechanical small bowel obstruction. Ann Surg. 1970;171(5):783-8.

McIver MA. Acute intestinal obstruction. Quoted by Cleator and Bowdin (1972). Am J Surg. 1933;19:63.

Abbas S, Bissett IP, Perry BR. Oral water soluble contrast for the management of adhesive small bowel obstruction. Cochrane Database Syst Rev. 2007;18:CD004651.

Saini DK, Chaudhary P, Durga C. Role of multislice computed tomography in evaluation and management of intestinal obstruction. Clin Pract. 2013;3(2):e20

Mallo RD, Salem R, Lalani T. Computed tomography diagnosis of ischemia and complete obstruction in small bowel obstruction: a systematic review. J Gastro-intest Surg. 2005;9:690-4.