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The value of MSCT in evaluating the passability of bezoar by conservative treatment for bezoars-induced small bowel obstruction

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Abstract

Purpose

To explore the multi-slice spiral computed tomography (MSCT) imaging characteristics of patients with bezoars-induced small bowel obstruction (BI-SBO) to evaluate the risk of conservative treatment.

Materials and methods

This retrospective study included 72 patients with BI-SBO who underwent whole-abdominal MSCT scan within 1 day before treatment. The patients were classified as the non-pass group and pass group depending on whether bezoar can pass after conservative treatment. The CT images were observed and measured by two radiologists. Statistical analysis was performed by using Student’s t test, Pearson’s chi-squared test, Fisher’s exact test, Logistic linear regression, and receiver operating characteristic curve (ROC).

Results

The study population consisted of 72 patients with a mean age of 52.2 ± 16.2 years (32 men and 40 women with an age range of 13–81 years). There were statistical differences between the two groups in the bezoar appearance, maximum HU of bezoar, thickness of intestinal wall, mesenteric haziness, mesenteric fluid, and peritoneal fluid (P = 0.002, 0.024, 0.017, 0.006, 0.021, and 0.030). The appearance of bezoar and mesenteric haziness is independent risk factors affecting whether bezoar can be passed by the conservative treatment. Sensitivity (41.7%) was decreased, NPV (76.3%) was not significantly changed, specificity (93.8%) and PPV (76.9%) were improved when both parameters were met to assess failure of conservative treatment.

Conclusion

The observation of important signs by MSCT and its reconstruction technology is of great clinical value in evaluating the passability of bezoar by conservative treatment, and which can provide radiographic basis for clinical treatment selection.

Graphical abstract

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Abbreviations

BI-SBO:

Bezoars-induced small bowel obstruction

MSCT:

Multi-slice spiral computed tomography

NPV:

Negative predictive value

PPV:

Positive predictive value

ROC:

Receiver-operating characteristic curve

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Funding

Funded by the Natural Science Foundation of Shandong Province (Grant No. ZR2018LH015).

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Author notes

  1. Xiaoyuan Gao and Yitong Hua have contributed equally to this work.

Authors and Affiliations

  1. Department of Radiology, Binzhou Medical University Hospital, No.661 Huanghe Second Road, Binzhou, 256603, Shandong, People’s Republic of China

    Xiaoyuan Gao, Lijie Dong, Lin Zhang, Xingyue Jiang & Liang Chen

  2. Department of Breast Surgery, Binzhou Medical University Hospital, Binzhou, 256603, Shandong, People’s Republic of China

    Yitong Hua

  3. Department of Gastroenterology, Wudi People’s Hospital, Binzhou, 256603, Shandong, People’s Republic of China

    Hongxiu Meng

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  1. Xiaoyuan Gao
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  5. Lin Zhang
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Contributions

Guarantors of integrity of entire study, XG, LC; study concepts/study design or data acquisition or data analysis/interpretation, all authors; manuscript drafting or manuscript revision for important intellectual content, all authors; approval of final version of submitted manuscript, all authors; agree to ensure any questions related to the work are appropriately resolved, all authors; literature research, XG, YH, LC; clinical studies, XG, LC, LD, LZ; experimental studies, all authors: statistical analysis, XG and LC; and manuscript editing, XG, LC, YH.

Corresponding author

Correspondence to Liang Chen.

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Conflict of interest

The study was conceived by the authors, and all data collection and analyses were done locally by the authors. The writing of all drafts of the manuscript and decision to publish were done by the authors alone. No external writing support was utilized. The authors have no other relevant conflicts of interest to disclose.

Ethical approval

This study was approved by our institutional review board.

Informed consent

Our retrospective study was approved by the institutional review board at participating site. The data are anonymous, and the requirement for informed consent was, therefore, waived.

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Gao, X., Hua, Y., Meng, H. et al. The value of MSCT in evaluating the passability of bezoar by conservative treatment for bezoars-induced small bowel obstruction. Abdom Radiol 48, 236–243 (2023). https://doi.org/10.1007/s00261-022-03700-4

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  • DOI: https://doi.org/10.1007/s00261-022-03700-4

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