Utility of Computed Tomography of Abdomen and Pelvis in Cases of Intestinal Obstruction

Abstract

Background: Bowel obstruction is a common clinical condition that occurs secondary to mechanical or functional obstruction of the bowel. It is a frequent cause of hospitalization and surgical consultation, representing 20% of all surgical admissions for acute abdominal pain. Objectives: To evaluate the level and cause of intestinal obstruction. Assess the accuracy of imaging findings in correlation with operative findings. Subjects and Methods: This is a prospective study of 43 patients who presented with acute intestinal obstruction to our hospital. All the subjects underwent CT scan of abdomen and pelvis in helical multi-detector CT scan machine. The CT scan of abdomen and pelvis findings was compared and correlated with intra-operative findings. Results: Out of 43 cases, 28 are males (65%) and 15 are females (35%). Only 17 cases (39.5%) had features of intestinal obstruction on the ultrasonography and only 13 cases (30%) had features of obstruction on abdominal radiography. This study showed 36 patients (83%) had small bowel obstruction and 7 (17%) had large bowel obstruction. In the small bowel, ileum was most common site to be obstructed accounting for about 63.8% of all small bowel obstruction. CT showed 100% correlation with intra-operative findings in assessing the level of obstruction. The most common cause for obstruction is post–operative adhesions which are seen in about 23.2 % cases. Conclusion: This study shows that CT is the imaging modality of choice in patients with acute intestinal obstruction to evaluate the level and cause of intestinal obstruction which did correlate well with intra-operative findings.