Adhesional small bowel obstruction: analysis of imaging signs on Multidetector CT: LTP59

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Aim:Review of the imaging features on CT inproven small bowel obstruction secondary to adhesions.Method:Multidetector CT (MDCT) imaging was performed in patients with symptoms of small bowel obstruction and images were analysed by a GI Radiologist. The location of bowel obstruction was identified and recorded. The imaging features were classified as abnormally dilated bowel with either an abrupt cut-off; abnormal bowel angulations; abnormal bowel orientation such as clustered bowel loops; obstruction of multiple segments of the bowel; any other imaging finding. The findings were then correlated with surgical findings.Results:In 39 patients, the sensitivity and specificity of 95% and 100% respectively in the diagnosis of adhesional obstruction. The most common type of imaging feature was that of dilated bowel with an abrupt cut-off (61.5%). Abnormal bowel angulation or kinking was seen in 20.5% of patients. A new finding observed was linear indentation seen across bowel segments in patients with adhesive bands.Conclusion:Although the most common finding is that of dilated bowel with an abrupt cut-off point as reported in scientific literature, several other types of imaging features can be observed. Knowledge of these imaging features can be useful in the accurate diagnosis of adhesional obstruction.

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