SMALL-BOWEL OBSTRUCTION - ROLE AND CONTRIBUTION OF SONOGRAPHY

The purpose of this study was to determine whether sonography provides additional clinical information in patients suspected of small bowel (SB) obstruction. During a period of 30 months, in a prospective setti ng, we evaluated with sonography 123 patients suspected of SB obstruct ion. Sonographic examinations of the entire abdomen were performed wit h state-of-the-art, real-time, grey-scale equipment. Fourteen patients were labelled 'gassy' and no added information was provided following abdominal ultrasound. Sonography confirmed the SB obstruction in 82 c ases with 5 false positives, resulting in a specificity of 82.1%. Sono graphic examinations were negative in 27 cases with 4 false negatives and a sensitivity of 95%. The accuracy was 91.7% when the 'gassy' pati ents were excluded and 81.3% overall. The aetiology of the ileus was d etected by sonography in 13 cases of paralytic ileus (54.1%) and in 57 cases of mechanical ileus (71.4%). It is concluded that ultrasound, w hich is a non-invasive, portable and even bedside imaging procedure, a ppears accurate in confirming a SB obstruction and in determining the aetiology of SB obstruction.