Usefulness of Contrast-enhanced Computed Tomography for the Diagnosis of Bowel Obstruction

Abstract

【Background】Since the pathogenesis of bowel strangulation (BS) involves bowel ischemia, contrast-enhanced computed tomography (CECT) is important for the diagnosis of BS. However, which CECT findings are most useful for an accurate diagnosis remain unclear. 【Method】The characteristics of 21 patients with necrotic BS and 33 patients with non-necrotic BS were examined. 【Results】A beak sign, a thick intestinal wall, and mesenteric edema were observed in over 70% of the patients with both necrotic and non-necrotic BS. Hypo-enhancement of the bowel wall was observed in 71% of the patients with necrotic BS and 18% of the patients with non-necrotic BS. 【Discussion】For the early diagnosis of BS, greater importance should be placed on the presence of a beak sign, thick intestinal wall, and mesenteric edema, with hypo-enhancement of the bowel wall being a lesser consideration.