The role of computed tomography signs in diagnosis of patients with small bowel obstruction

Aim: The goal of this prospective study is to evaluate the prognostic impact of computed tomography (CT) signs in the analysis of small bowel obstruction (SBO). Patients and Method: Sixty consecutive patients with acute abdominal pain who were examined using abdominal CT to diagnose SBO were included in the study. 47 patients of them (26 male; 21 female and mean age, 60 years), were evaluated. CT evaluation parameters were mesenteric congestion, transition zone, feces sign, intramural air and intraperitoneal free fluid. Results: There was a statistically significant association between the SBO diagnosis and CT findings for mesenteric congestion, transition zone and intramural air (p<0.05 for all). These CT signs had greatest sensitivity and positive predictive value (PPV) in diagnosis of SBO. The combination of mesenteric congestion, transition zone and in-tramural air showed a significant association in the diagnosis of SBO (p<0.05). Small bowel feces sign and intraperitoneal free fluid findings had no statistically significant value in the diagnosis of SBO (p>0.05). When three or more CT findings were seen together, there was a statistically significant association in the diagnosis (p<0.05). Conclusion: Mesenteric congestion and transition zone had the highest sensitivity and PPV in diagnosing SBO. The combination of mesenteric congestion, transition zone and intramural air and the presence of three or more CT signs markedly increase the specificity in diagnosis of SBO