Role of multi-slice computed tomography in evaluation and management of intestinal obstruction


  • Raja Waseem M. Department of Radiology, Osh State Medical University, Kyrgyzstan
  • Zahid M. Rather Department of Surgery, Osh State Medical University, Kyrgyzstan
  • Nighat Ara Majid Department Gynaecology and Obstetrics, Osh State Medical University, Kyrgyzstan
  • M. Nazrull Islam Department of Surgery, Osh State Medical University, Kyrgyzstan
  • Ydyrysova Ismatilla Toktosunovich Department of Surgery, Osh State Medical University, Kyrgyzstan



Intestinal obstruction, Clinical examination, CT scan, Conservative/ surgical management


Background: The purpose of this study is to evaluate the role of multi-slice computed tomography (CT) with reference to presence or absence of intestinal obstruction, level of obstruction, the cause of obstruction, and correlating with their clinical diagnosis.

Methods: Patients were admitted directly from Out Patient Department or emergency department with complaints suggestive of intestinal obstruction. Computed tomography scan interpretations performed by experienced radiologists were compared with the final diagnosis that was made on the basis of information obtained clinically, by investigations, and by surgical findings.

Results: Majority of patients were males 62%. Mean age 51.62±17.46 years. Majority presents with abdominal pain 94% and constipation 72%.The most common cause of obstruction was adhesion bands 18%.The pre CT diagnosis was changed because of CT findings in 28 patients. Only in 50 (89.28%) patients CT findings matched with intra-operative and cause of obstruction was also found, and in 6 (10.71%) patients intra-operative findings are different from CT findings. In bowel obstruction, the CT sensitivity was 89.28%, specificity 90.90%, positive predictive value 92.59%, negative predictive value 86.95% and accuracy 92.59%.

Conclusions: We concluded that multi-slice CT is highly sensitive and specific in determining the presence, the cause and site of bowel obstruction, the site of obstruction and cause of obstruction. We recommended the use of CT scan when diagnosis between ileus and obstruction on the basis of clinical and plain radiographic are difficult or in patients in whome small bowel obstruction is diagnosed when conservative management is contemplated.


Mucha P. Small intestinal obstruction. Surg Clin North Am. 1987;67:597.

Miller G, Boman J, Shrier I, Gordon PH. Natural history of patients with adhesive small bowel obstruction. Br J Surg. 2000;87:1240.

Wright HK, O'Brien JJ, Tilson MD. Water absorption in experimental closed segment obstruction of the ileum in man. Am J Surg. 1971;121:96.

Mourad B, Philippe S, Carine T, Jean PP, Emmanuelle M, Roland R. CT evaluation of small bowel obstruction. RadioGraphics. 2001;21:613–24.

Maglinte Dean DT, Heitkamp Darel E, Howard Thomas J, Kelvin Frederick M, Lappas John C. Current concepts in imaging of small bowel obstruction. Radiol Clin N Am. 2003;41:263–83.

Scott FI, Osterman MT, Mahmoud NN, Lewis JD. Secular trends in small-bowel obstruction and adhesiolysis in the United States: 1988-2007. Am J Surg. 2012;204:315.

Drożdż W, Budzyński P. Change in mechanical bowel obstruction demographic and etiological patterns during the past century: observations from one health care institution. Arch Surg. 2012;147:175.

Frager D, Medwin SW, Baer JW. CT of small bowel obstruction: value in establishing the diagnosis and determining the degree and cause. Am J Roentgenol. 1994;162:37-41.

Gazekke GS, Goldberg MA, Wittenberg J, Halpern EF. Efficacy of CT in distinguishing small-bowel obstruction from other causes of small-bowel dilatation. Am J Roentgenol. 1994;162:43-7.

Mallo RD, Salem R, Lalani T. Computed tomography diagnosis of ischemia and complete obstruction in small bowel obstruction: a systematic review. J Gastrointest Surg. 2005;9:690-4.

Caoili EM, Paulson EK. CT of small-bowel obstruction: another perspective using multiplanar reformations. AJR Am J Roentgenol. 2000;174:993–8.

Randen A, Lamérisa W, Luitse JSK. The role of plain radiographs in patients with acute abdominal pain at the ED. Am J Emerg Med. 2011;29:582-9-2.

Achiek MM, Tawad FK, Ladu JD. Where there is no CT scan plain abdominal X-ray suffices to diagnose and manage bowel obstruction. Sudan Med J. 2016;52(1).

Staniland JR, Ditchburn J, De Dombal FT. Clinical presentation of acute abdomen: study of 600 patients. Br Med J. 1972;3(5823):393-8.

Burdett JW, Stevens LL. The clinical management of intestinal obstruction. Arch Surg. 1961;83:134-45.

Saini DK, Chaudhary P, Durga C. Role of multislice computed tomography in evaluation and management of intestinal obstruction. Clin Pract. 2013;3(2):1-20.

Suri S, Gupta S, Sudhakar PJ, Venkataramu NK, Sood B, Wig JD, et al. Comparative evaluation of plain films, ultrasound and CT in the diagnosis of intestinal obstruction. Acta Radiol. 1999;40:422–8.

Mallo RD, Salem R, Lalani T. Computed tomography diagnosis of ischemia and complete obstruction in small bowel obstruction: a systematic review. J Gastro -intest Surg. 2005;9:690-4.

Megibow AJ, Balthazar EJ, Cho CK. Bowel obstruction: evaluation with CT. Radiology. 1991;180:313-8.

Fukuya T, Hawes D, Lu C. CT diagnosis of small-bowel obstruction: efficacy in 60 patients. Am J Roentgenol. 1992;158:765-9.






Original Research Articles