THE CT SMALL-BOWEL FECES SIGN - DESCRIPTION AND CLINICAL-SIGNIFICANCE

Objective: To describe a new CT sign of the GI tract: the small bowel faeces sign, and discuss its significance. Methods: The small bowel fa eces sign consists of gas bubbles mixed with particulate matter in dil ated segments of small bowel. This was a retrospective study of 22 pat ients demonstrating this sign from 1989 to 1993. Final diagnosis was e stablished by surgical, medical or laboratory findings. To determine t he prevalence of the sign, the CT examination of 120 consecutive separ ate control patients were evaluated. Results: All 22 of the patients d emonstrating this sign required hospitalization with surgical or medic al intervention. Eighteen of 22 had mechanical small bowel obstruction . The remaining four patients had other abnormalities of small bowel t o account for the Ending on CT. Twelve of the 22 patients were treated with surgery and the remaining 10 patients were treated with nasogast ric tubes (n = 6) or other medical therapy (n = 4). None of the 120 co ntrol patients demonstrated the sign. Conclusion: The presence of gas and particulate material resembling faeces in a dilated segment of sma ll bowel on CT is abnormal. Most (18/22; 82%) patients with this sign had small bowel obstruction.