Small Bowel Obstruction

Chapter
Part of the Radiology Illustrated book series (RADILL)

Abstract

Small bowel obstruction (SBO) is one of the most common causes of acute nontraumatic abdominal pain and a frequent cause of hospitalization and surgery. Traditional management for SBO has been surgery owing to previously unreliable clinical features as well as insufficient information from radiographs. However, with recent advances, MDCT has been shown to accurately determine the presence or absence of SBO, identify the site and cause of the obstruction, and detect closed-loop obstructions and strangulations. Today, MDCT has become a powerful tool for the assessment of SBOs, playing an important role in the management of patients with SBOs. In this chapter, the definitions encountered in SBO and imaging modalities for SBO evaluation with an emphasis on MDCT are briefly reviewed. In addition, imaging findings of SBO using an algorithmic approach are provided with representative figures.

Keywords

Ischemia Adenocarcinoma Perforation Peritoneal Inflammation Ileal 

Abbreviations

CT

Computed tomography

MDCT

Multidetector-row computed tomography

SBO

Small bowel obstruction

References

  1. Elsayes KM, Menias CO, Smullen TL, Platt JF. Closed-loop small-bowel obstruction: diagnostic patterns by multidetector computed tomography. J Comput Assist Tomogr. 2007;31:697–701.PubMedCrossRefGoogle Scholar
  2. Filippone A, Cianci R, Grassedonio E, Di Fabio F, Storto ML. Four-section multidetector computed tomographic imaging of bowel obstruction: usefulness of axial and coronal plane combined reading. J Comput Assist Tomogr. 2007;31:499–507.PubMedCrossRefGoogle Scholar
  3. Harlow C, Stears RL, Zeligman B, Archer PG. Diagnosis of bowel obstruction on plain abdominal radiographs: significance of air-fluid levels at different heights in the same loop of bowel. AJR Am J Roentgenol. 1993;161:291–5.PubMedCrossRefGoogle Scholar
  4. Jaffe TA, Martin LC, Thomas J, Adamson AR, DeLong DM, Paulson EK. Small-bowel obstruction: coronal reformations from isotropic voxels at 16-section multi-detector row CT. Radiology. 2006;238:135–42.PubMedCrossRefGoogle Scholar
  5. Kim JH, Ha HK, Kim JK, Eun HW, Park KB, Kim BS, et al. Usefulness of known computed tomography and clinical criteria for diagnosing strangulation in small-bowel obstruction: analysis of true and false interpretation groups in computed tomography. World J Surg. 2004;28:63–8.PubMedCrossRefGoogle Scholar
  6. Kohli MD, Maglinte DD. CT enteroclysis in incomplete small bowel obstruction. Abdom Imaging. 2009;34:321–7.PubMedCrossRefGoogle Scholar
  7. Lazarus DE, Slywotsky C, Bennett GL, Megibow AJ, Macari M. Frequency and relevance of the “small-bowel feces” sign on CT in patients with small-bowel obstruction. AJR Am J Roentgenol. 2004;183:1361–6.PubMedCrossRefGoogle Scholar
  8. Miller G, Boman J, Shrier I, Gordon PH. Etiology of small bowel obstruction. Am J Surg. 2000;180:33–6.PubMedCrossRefGoogle Scholar
  9. Mullan CP, Siewert B, Eisenberg RL. Small bowel obstruction. AJR Am J Roentgenol. 2012;198:W105–17.PubMedCrossRefGoogle Scholar
  10. Nevitt PC. The string of pearls sign. Radiology. 2000;214:157–8.PubMedCrossRefGoogle Scholar
  11. Shrake PD, Rex DK, Lappas JC, Maglinte DD. Radiographic evaluation of suspected small bowel obstruction. Am J Gastroenterol. 1991;86:175–8.PubMedGoogle Scholar
  12. Silva AC, Pimenta M, Guimaraes LS. Small bowel obstruction: what to look for. Radiographics. 2009;29:423–39.PubMedCrossRefGoogle Scholar
  13. Zalcman M, Sy M, Donckier V, Closset J, Gansbeke DV. Helical CT signs in the diagnosis of intestinal ischemia in small-bowel obstruction. AJR Am J Roentgenol. 2000;175:1601–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2015

Authors and Affiliations

  1. 1.Department of RadiologySeoul National University HospitalSeoulRepublic of Korea

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