The role of computed tomography in the diagnosis of acute adhesive small bowel obstruction

Purpose of the study: to determine the role of multislice computed tomography (MSCT) in the diagnostic algorithm for the management of patients with acute adhesive small bowel obstruction.

Materials and methods. The study included 168 patients undergoing inpatient treatment from 2015 to 2019 with a diagnosis of acute small bowel obstruction. The obturation form of acute adhesive small bowel obstruction (AASBO) was detected in 151 patients, while 17 patients have strangulation form of obstruction. The study compared two groups of patients who differ in the examination algorithm:

Group I – “traditional” approach – 74 patients who used X-ray (plain radiography, with passage assessment) and ultrasound to diagnose intestinal obstruction.

Group II – “proposed” algorithm, included 94 patients whose diagnostic complex, in addition to the methods described above, was supplemented with MSCT with enterography.

Results. In the group of "proposed" algorithm, the sensitivity, specificity and accuracy of MSCT was 99.7%, 86.6%, 97.8%, respectively, in the diagnosis of the obturation AASBO, and the resolution of the obstruction was detected significantly earlier than in the "traditional" group (p = 0.0081).

Conclusion. Computed tomography is the most accurate method of diagnosing the presence, cause and level of intestinal obstruction; in addition, it is the most effective way to evaluate the efficacy of conservative therapy.

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