Role of Computed Tomography in Evaluation of Different Causes of Intestinal Obstruction Correlated with Operative Findings

Background: Computed tomography (CT) is now widely used to diagnose intestinal obstruction. This is due to a significant shift in the approach to managing obstruction, resulting in a decline in the number of patients requiring surgical intervention. Objective: The objective of this study was to assess the diagnostic accuracy of multi-detector computed tomography (MDCT) in detecting intestinal obstruction and determine the site, causes, and severity of the obstruction by comparing the results with intraoperative findings, which are considered the most reliable standard. Patients and Methods: This study is a prospective cohort observational study that analyzed 80 patients who reported to the surgical emergency unit with symptoms of abdominal pain, abdominal distension, inability to pass feces and flatus. The patients included both males and females and were between the ages of 18 and 70 years. CT scans were performed and revealed intestinal dilatation, transition area between the dilated and collapsed loops and mesenteric fat stranding, The radiologist prepared the report based on surgical findings documented in operative notes that provided by the surgeon who performed the operation on the same patient. Results: Regarding socio-demographic characteristics,the mean age of the studied patients was 49.54±16.34 years. Furthermore, 53(66.3%) if patients were males and 27(33.8%) of them were females. Intestinal adhesion, colorectal cancer, obstructed hernia were the commonest causes of IO final diagnosis detected 25(31.25%), 20(25%) and 12(15%) cases respectively. Assessment of diagnostic accuracy of multi-detector computed tomography scan in diagnosing intestinal adhesion, taking operative findings as a gold standard revealed that sensitivity was (98%), specificity (62.5%), positive predictive value (95.9%), and negative predictive value (83.3%). Conclusions: MDCT is particularly essential in detecting many small bowel diseases. MDCT is effective in evaluating both obstructive and non-obstructive lesions. MDCT is highly accurate in determining the amount and source of blockage.