OBSTRUCTION OF THE SMALL-INTESTINE - ACCURACY AND ROLE OF CT IN DIAGNOSIS

The reliability of abdominal computed tomography (CT) in the assessmen t of varying degrees of small bowel obstruction (SBO) was evaluated by using results at enteroclysis and clinical outcome as standards of re ference. A blinded retrospective analysis was performed of the studies of 55 patients who underwent both CT and enteroclysis in the course o f assessment for suspected SBO. Nine patients had no obstruction, 40 p atients had obstruction due to adhesions, and six patients had tumor-r elated obstruction. CT results were used to identify correctly 63% (29 of 46) of those who had SBO and 78% (seven of nine) of the patients w ho did not. The overall accuracy of the CT interpretations to help est ablish diagnosis was 65% (36 of 55). When obstructions were classified into low- and high-grade partial obstruction, CT results could be use d to identify correctly 81% (17 of 21) of high-grade SBOs and 48% (12 of 25) of low-grade SBOs. The procedure yielded two false-positive and 13 false-negative results for patients with low-grade obstruction, re vealed masses in all six cases with tumor-related obstruction, and hel ped predict the correct cause in all true-positive cases.