Format

Send to

Choose Destination
Abdom Radiol (NY). 2016 Jul;41(7):1253-60. doi: 10.1007/s00261-016-0656-4.

Diagnostic performance of MDCT in identifying closed loop small bowel obstruction.

Author information

1
Department of Radiology, Duke University Medical Center, Box 3808, Durham, 27710, NC, USA.
2
Department of Surgery, Duke University Medical Center, Durham, NC, USA.
3
Department of Radiology, Duke University Medical Center, Box 3808, Durham, 27710, NC, USA. jaffe002@mc.duke.edu.

Abstract

PURPOSE:

To assess the diagnostic performance of MDCT in the diagnosis of closed loop small bowel obstruction.

MATERIALS AND METHODS:

One hundred fifty patients with CT reports including "small bowel obstruction (SBO)" between 1/30/2011 and 12/4/2012 were included (65 men, 85 women, mean age 63 years). CT examinations were independently and blindly reviewed by five radiologists to determine the presence of closed loop obstruction (CL-SBO) and to assess findings of bowel ischemia. Clinical records were reviewed to determine management and operative findings. Using operative findings as a gold standard, reader agreement for the diagnosis of and the CT findings associated with CLO was analyzed using Pearson's correlation (r). Positive predictive value (PPV) and negative predictive value for the diagnosis of CL-SBO and CT signs of bowel ischemia were analyzed.

RESULTS:

Eighty-eight of 150 patients underwent operative intervention for SBO and 24/88 were considered CL-SBO operatively. Average reader sensitivity and specificity for CL-SBO was 53 % (95 % CI 44-63 %) and 83 % (95 % CI 79-87 %). Reader agreement on CL-SBO was poor to moderate (K = 0.39-0.63). Reader agreement for CT signs of bowel ischemia resulting in a diagnosis of CL-SBO was weak (r = 0.19-0.32).

CONCLUSION:

The CT diagnosis of CL-SBO is complex and associated imaging findings have variable sensitivity for predicting a closed loop operative diagnosis. CT can be helpful in excluding a closed loop component in patients with SBO.

KEYWORDS:

CT; Closed loop; Small bowel obstruction

PMID:
26830421
DOI:
10.1007/s00261-016-0656-4
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center