Seminars in Ultrasound, CT and MRI
Volume 24, Issue 5 , Pages 336-352 , October 2003

CT diagnosis of small bowel obstruction: scanning technique, interpretation and role in the diagnosis

  • Akira Furukawa, MD

      Affiliations

    • Department of Radiology, Shiga University of Medical Science, Otsu, Japan
    • Corresponding Author InformationAddress reprint requests to Akira Furukawa, MD, Department of Radiology, Shiga University of Medical Science, Seta Tsukinowa-cho Otsu Shiga 520-2192, Japan
    • ,
  • Michio Yamasaki, MD

      Affiliations

    • Department of Radiology, Shiga University of Medical Science, Otsu, Japan
    • ,
  • Masashi Takahashi, MD

      Affiliations

    • Department of Radiology, Shiga University of Medical Science, Otsu, Japan
    • ,
  • Norihisa Nitta, MD

      Affiliations

    • Department of Radiology, Shiga University of Medical Science, Otsu, Japan
    • ,
  • Toyohiko Tanaka, MD

      Affiliations

    • Department of Radiology, Shiga University of Medical Science, Otsu, Japan
    • ,
  • Shuzo Kanasaki, MD

      Affiliations

    • Department of Radiology, Kouseikai Takeda Hospital, Kyoto, Japan
    • ,
  • Kenji Yokoyama, MD

      Affiliations

    • Department of Radiology, Shin Kori Hospital, Hirakata, Japan
    • ,
  • Kiyoshi Murata, MD

      Affiliations

    • Department of Radiology, Shiga University of Medical Science, Otsu, Japan
    • ,
  • Tsutomu Sakamoto, MD

      Affiliations

    • Department of Radiology, Koga Public Hospital, Koga, Japan

References 

  1. McFadden DW, Zinner MJ. Manifestation of gastrointestinal disease. In:  Cshwartz SI,  Shires GT,  Spencer FC editor. Principles of Surgery. New York: Mcgraw-Hill; 1994;p. 1015–1042
  2. Taourel P, Kessler N, Lesnik A. Non-traumatic abdominal emergencies (Imaging of acute intestinal obstruction). Eur Radiol. 2002;12:2151–2160
  3. Ahn SH, Mayo-Smith WW, Murphy BL, Reinert SE, Cronan JJ. Acute nontraumatic abdominal plain in adult patients (Abdominal radiography compared with CT evaluation). Radiology. 2002;225:159–164
  4. Maglinte DDT, Heitkamp DE, Howard TJ, Kelvin FM, Lappas JC. Current concept in imaging of small bowel obstruction. Radiol Clin N Am. 2003;41:263–283
  5. Lappas JC, Reyes BL, Maglinte DDT. Abdominal radiography findings in small-bowel obstruction (Relevance to triage for additional diagnostic imaging). AJR Am J Roentgenol. 2001;176:167–174
  6. Frager DH, Baer JW. Role of CT in evaluating patients with small-bowel obstruction. Semin Ultrasound CT MRI. 1995;16:127–140
  7. Frager D, Medwid SW, Baer JW, et al.  CT of small bowel obstruction. Value in establishing the diagnosis and determining the cause. AJR Am J Roentgenol. 1994;162:37–41
  8. Mucha P. Small intestinal obstruction. Surg Clin North Am Surg Clin North Am. 1987;67:597–620
  9. Markus JB, Somers S, Slobodan ER, et al.  Interobserver variation in the interpretation of abdominal radiographs. Radiology. 1989;171:69–71
  10. Herlinger H, Rubesin SE, Morris JB. Small bowel obstruction. In:  Gore RM,  Levine MS editor. Textbook of Gastrointestinal Radiology. ed. 2nd. Philadelphia: W. B. Saunders Co; 2000;p. 815–837
  11. Shrake PD, Rex DK, Lappas JC, et al.  Radiographic evaluation of suspected small bowel obstruction. Am J Gastroenterol. 1991;86:175–178
  12. Maglinte DDT, Kelvin FM, Rowe MG, et al.  Small-bowel obstruction (Optimizing radiologic investigation and nonsurgical management). Radiology. 2001;218:39–46
  13. Maglinte DDT, Bender GN, Heikamp DE, et al.  Multidetector-row helical CT enteroclysis. Radiol Clin N Am. 2003;41:249–262
  14. Matsuoka H, Takahara T, Masaki T, et al.  Preoperative evaluation by magnetic resonance imaging in patients with bowel obstruction. Am J Surg. 2002;183:614–617
  15. Low RN, Chen SC, Barone R. Distinguishing benign from malignant bowel obstruction in patients with malignancy (Findings at MR imaging). Radiology. 2003;228:157–165
  16. Beall DP, Fortman BJ, Lawler BC, et al.  Imaging bowel obstruction (A comparison between fast magnetic resonance imaging and helical computed tomography). Clin Radiol. 2002;57:719–724 Aug
  17. Balthazar EJ. CT of small-bowel obstruction. AJR Am J Roentgenol. 1994;162:255–261
  18. Frager DH, Baer JW, Rothpearl A, et al.  Distinction between postoperative ileus and mechanical small-bowel obstruction (Value of CT compared with clinical and other radiographic findings). AJR Am J Roentgenol. 1995;164:891–894
  19. Gazelle GS, Gold berg MA, Wittenberg J, et al.  Efficacy of CT in distinguishing small-bowel obstruction from other causes of small-bowel dilatation. AJR Am J Roentgenol. 1994;162:43–47
  20. Maglinte DD, Reyes BL, Harmon BH, et al.  Reliability and role of plain film radiography and CT in the dagnosis of small-bowel obstruction. AJR Am J Roentgenol. 1996;167:1451–1455
  21. Suri S, Gupta S, Sudhakar PJ, et al.  Comparative evaluation of plain films, ultrasound and CT in the diagnosis of intestinal obstruction. Acta Radiol. 1999;40:422–428
  22. Fukuya T, Hawes D, Lu C, et al.  CT diagnosis of small-bowel obstruction (Efficacy in 60 patients). AJR Am J Roentgenol. 1992;158:765–769
  23. Mayo-Smith W, Wittenberg J, Bennett GL, et al.  The CT small bowel faeces sign (Description and clinical significance). Clin-Radiol. 1995;50:765–767
  24. Megibow AJ, Balthazar EJ, Cho CK, et al.  Bowel obstruction (Evaluation with CT). Radiology. 1991;180:313–318
  25. Maglinte DD, Gage SN, Harmon BH, et al.  Obstruction of the small intestine (Accuracy and role of CT in diagnosis). Radiology. 1993;188:61–64
  26. Macari M, Megibow A. Imaging of suspected acute small bowel obstruction. Semin Roentgenol. 2001;36:108–117
  27. Furukawa A, Yamasaki M, Furuichi K. Helical CT in the diagnosis of small bowel obstruction. RadioGraphics. 2001;21:341–355
  28. Caoili EM, Paulson EK. CT of small-bowel obstruction (another perspective using multiplanar reformations). AJR Am J Roentgenol. 2000;174:993–998
  29. Khurana B, Ledbetter S, McTavish J, et al.  Bowel obstruction revealed by multidetector CT. Am J Roentgenol. 2002;178:1139–1144
  30. Wiesner W, Khurana B, Ji H, Ros PR. CT of acute bowel ischemia. Radiology. 2003;226:635–650
  31. Zalcman M, Sy M, Donckier V, Closset J, Gansbeke DV. Helical CT signs in the diagnosis of intestinal ischemia small-bowel obstruction. AJR. 2000;175:1601–1607
  32. Maglinte DDT, Bender GN, Heitkamp DE, Lappas JC, Kelvin FM. Multidetector-row helical CT enteroclysis. Radiol Clin North Am. 2003;41:249–262
  33. Umschaden HW, Gasser J. MR enteroclysis. Radiol Clin North Am. 2003;41:231–248
  34. Umschaden HW, Szolar D, Gasser J, et al.  Small-bowel disease (Comparison of MR enteroclysis images with conventional enteroclysis and surgical findings). Radiology. 2000;215:717–725
  35. Rptopoulos V, Schwartz RK, McNicholas MM, Movson J, Pearlman J, Joofe N. Multiplanar helical CT enterography in patients with Crohn’s disease. AJR. 1997;169:1545–1550
  36. Bizer LS, Liebling RW, Delany HM, et al.  Small bowel obstruction (The role of non-operative treatment in simple intestinal obstruction and predictive criteria for strangulation obstruction). Surgery. 1981;89:407–413
  37. Livingstone AS, Sosa JL. Ileus and obstruction. In:  Haubrich WS,  Schaffner F,  Berk JE editor. Bockus Gastroenterology. ed. 5th. Philadelphia: W. B. Saunders Co; 1995;p. 1235–1248
  38. Herlinger H, Maglinte DDT. Small bowel obstruction. In:  Herlinger H,  Maglinte DDT editor. Clinical Radiology of the Small Intestine. ed. 1nd. Philadelphia: W. B. Saunders Co; 1989;p. 479–507
  39. Ellis H. The causes and prevention of intestinal adhesions. Br J Surgery. 1982;69:241–243
  40. McEntee G, Pender D, Mulvin D, et al.  Current spectrum of intestinal obstruction. Br. J Surg. 1987;74:976–980
  41. Ghahremani GG. Abdominal and pelvic hernias. In:  Gore RM,  Levine MS editor. Textbook of Gastrointestinal Radiology. ed 2nd. Philadelphia: W. B. Saunders Co; 2000;p. 1993–2009
  42. Toms AP, Cash CCJ, Fernando B, et al.  Abdominal wall hernias (Cross-sectional pictorial review). Semin Ultrasound CT MRI. 2002;23:143–155
  43. Blachar A, Federle MP. Internal hernia (An increasingly common cause of small bowel obstruction). Semin Ultrasound CT MRI. 2002;23:174–183
  44. Blachar A, Federle MP, Brancatelli G, et al.  Radiologist Performance in the Diagnosis of Internal Hernia by Using Specific CT Findings with Emphasis on Transmesenteric Hernia. Radiology. 2001;221:422–428
  45. Blachar A, Federle MP. Bowel Obstruction Following Liver Transplantation (Clinical and CT Findings in 48 Cases with Emphasis on Internal Hernia). Radiology. 2001;218:384–388
  46. Campo LD, Arribas I, Valbuena M, Mta Jose , Moreno-Otero R. Spiral CT Findings in active and remission phases in patients with Crohn disease. J Comput Assist Tomogr. 2001;25:792–797
  47. Lee SS, Ha HK, Yang S-K, et al.  CT of prominent pericolic or perienteric vasculature in patients with Crohn’s disease (Correlation with clinical disease activity and findings on barium studies). AJR Am J Roentgenol. 2002;179:1029–1036
  48. Reijnen-Han AM, Joosten-Harrie JM, deBoer-Herman HM. Diagnosis and treatment of adult intussusception. Am J Surg. 1989;158:25–28
  49. Agha FP. Review; Intussusception in adults. AJR Am J Roentgenol. 1986;146:527–531
  50. Warshauer DM, Lee JKT. Adult intussusception detected at CT or MR imaging (Clinical-imaging correlation). Radiology. 1999;212:853–860
  51. Iko BO, Teal JS, Siran SM, et al.  Computed tomography of adult colonic intussusception (Clinical and experimental studies). AJR Am J Roentgenol. 1984;143:769–772
  52. Lorgan JG, DuBrow RA. The computed tomographic appearances and clinical significance of intussusception in adults with malignant neoplasms. Br J Radiol. 1990;63:257–263
  53. Yoshimitsu F, Fukuya T, Onitsuka H, et al.  Computed tomography of ileocolic intussusception caused by a lipoma. J Comput Assist Tomogr. 1989;13:704–706
  54. Rigler LG, Bormen CN, Noble JF. Gallstone obstruction (Pathogenesis and roentgen manifestations). JAMA. 1941;77:1753
  55. Grumbach K, Levine MS, Wexler JA. Gallstone ileus diagnosed by computed tomography. J Comput Assist Tomogr. 1986;10:146–148
  56. Bloom RR, Nakano PH, Gray SW, et al.  Foreign bodies of the gastrointestinal tract. Am J Surg. 1986;52:618–621
  57. Herlinger H, Maglinte DDT. Miscellaneous disorders. In:  Herlinger H,  Maglinte DDT editor. Clinical Radiology of the Small Intestine. ed. 1st. Philadelphia: W. B. Saunders Co; 1989;p. 509–540
  58. Balthazar EJ, Birnbaum BA, Megibow AJ, et al.  Closed-loop and strangulating intestinal obstruction (CT signs). Radiology. 1992;185:769–775
  59. Sarr MG, Bulkley GB, Zuidema GD. Preoperative recognition of intestinal strangulation obstruction (prospective evaluation of diagnostic capability). Am J Surg. 1983;145:176–182
  60. Megibow AJ. Bowel obstruction (evaluation with CT). Radiol Clin North Am. 1994;32:861–870
  61. Chakrabarty P, Tripathy B, Panda K. Acute intestinal obstruction (a review of 1020 operated cases). J Indian Med Assoc. 1976;64:64–69
  62. Laws H, Aldrete J. Small bowel obstruction (A review of 465 cases). South Med J. 1976;69:733–744
  63. Zalcman M, Gansbeke V, Lalmand B, et al.  Delayed enhancement of the bowel wall (a new CT sign os small Bowel strangulation). J Comput Assist Tomogr. 1996;20:379–381
  64. Frager D, Baer JW, Medwid SW, et al.  Detection of intestinal ischemia in patients with acute small-bowel obstruction due to adhesion or hernia (efficacy of CT). AJR Am J Roentgenol. 1996;166:67–71
  65. Federle MP, Chun G, Jeffrey RB, et al.  Computed tomographic findings in bowel infarction. AJR Am J Roentgenol. 1984;142:91–95
  66. Alpem MB, Glazer GM, Francis IR. Ischemic or infarcted bowel (CT findings). Radiology. 1988;166:149–152
  67. Smerud MJ, Johnsos CD, Stephens DH. Diagnosis of bowel infarction (A comparison of plain films and CT scans in 23 cases). AJR Am J Roentgenol. 1990;154:99–103
  68. Ha HK, Park CH, Kim SK, et al.  CT analysis of intestinal obstruction due to adhesion (Early detection of strangulation). J Comput Assist Tomogr. 1993;17:386–389
  69. Balthazar EJ, Liebeskind ME, Macari Michael. Intestinal ischemia in patients in whom small bowel obstruction is suspected (Evaluation of accuracy limitations, and clinical implications of CT in diagnosis). Radiology. 1997;205:519–522
  70. Ha H, Kim JS, Lee MS, et al.  Differentiation of simple and strangulated small-bowel obstructions (Usefulness of known CT criteria). Radiology. 1997;204:507–512
  71. Schrock TR. Small intestine. In:  Way LW editors. Current surgical diagnosis and treatment. Norwalk: Appleton and Lange; 1988;p. 561–585
  72. Taourel PG, Fabre JM, Prafel JA, et al.  Value of CT in the diagnosis and management of patients with suspected acute small-bowel obstruction. AJR Am J Roentgenol. 1995;165:1187–1192

PII: S0887-2171(03)00076-3

doi: 10.1016/j.sult.2003.08.001

Seminars in Ultrasound, CT and MRI
Volume 24, Issue 5 , Pages 336-352 , October 2003

Article Tools

* Image Usage & Resolution