CT Assessment of Bowel Obstruction Site and Aetiology and Correlation with Surgical Findings: Experience in a Tertiary Care Teaching Hospital.

Dr.Sarthak Kesarwani; Dr. Sameer R. Verma; Dr. Sonal Saran; Dr.Shubda Sagar

Volume : IX, Issue : IV, April - 2019

CT Assessment of Bowel Obstruction Site and Aetiology and Correlation with Surgical Findings: Experience in a Tertiary Care Teaching Hospital.

Dr. Sarthak Kesarwani, Dr. Sameer R. Verma, Dr. Sonal Saran, Dr. Shubda Sagar

Abstract :

Inroduction: Bowel obstruction is responsible for approximately 20% of surgical admissions for acute abdominal conditions. CT plays an important role in revealing the site and aetiology of obstruction and its complications. Aim: To assess the site and aetiology of bowel obstruction using CT and correlation with surgical findings. Materials and Methods: This was a prospective study conducted on 70 patients with bowel obstruction, diagnosed on CT. X–ray and ultrasound abdomen was also done in all the patients.56(80%) patients were operated while 14(20%) were managed conservatively. CT findings were correlated with operative findings and analyzed statistically. Results: Out of 70 patients, 29 (41%) were males and 41 (59%) were females. The most frequently encountered symptom was abdomen distention (88%). The site of obstruction diagnosed on CT was ileum (44%), I–C junction (13%), jejunum (10%), duodenum(6%), colon (6%) and rectum (3%). Benign stricture(33%) and adhesions(20%) were the most common causes of obstruction diagnosed on CT. Regarding site of obstruction, CT and operative findings were concordant in 39(70%) of the patients and for cause of obstruction, CT and operative findings were concordant in 35(62%) of the patients. The sensitivity and specificity of CT for the site of obstruction was 71% & 93.3% respectively, while the sensitivity and specificity of CT for the cause of obstruction was 63.3% & 93.3% respectively. Conclusion: CT has high specificity with moderate sensitivity in diagnosing site and cause of bowel obstruction. This study shows high degree of agreement between CT and operative findings.