CT diagnosis and surgical treatment of adhesive ileus

Abstract

Objective To analyze CT findings in adhesive intestinal obstruction caused by different adhesion pattern. Methods Clinical data of 83 adhesive intestinal obstruction cases proved by laparotomy were reviewed. Before surgery two experienced abdominal radiologists randomly double blindly inspected and evaluated the CT findings, as to whether there was intestinal obstruction, the severity of obstruction, the site of obstruction, the adhesion type of obstruction and the diagnosis of strangulated intestinal obstruction, the consensuses were accomplished by discussion. Results The accuracy of diagnosis was 100% for the existence of obstruction, the severity of obstruction and the site of obstruction. There were intra-abdominal hernia caused by intestinal adhesion (44 cases), a cluster of loop (12 cases), bowel twisted angle (8 cases), the intestine and abdominal adhesions (6 cases), intestinal adhesion contracture stenosis (5 cases), adhesive band compression (4 cases), intestinal volvulus caused by adhesion (1 case). The accuracy, sensitivity, specificity, positive predictive value and negative predictive value of CT in diagnosing strangulated intestinal obstruction were 78%, 47%, 100%, 100%, 73%, respectively. Conclusion CT can clearly diagnose different adhesion pattern leading to ileus and ensuing strangulation. Key words: Intestinal obstruction; Tomography, X-ray computed; Adhesions