CT findings ID Tx effectiveness in small-bowel obstruction

(HealthDay)—Computed tomographic (CT) findings can predict the effectiveness of nonsurgical treatment in patients with adhesive small-bowel obstruction (SBO), according to a study published in the November issue of Radiology.

Ingrid Millet, M.D., from Hôpital Lapeyronie in Montpellier, France, and colleagues conducted a retrospective study to examine CT findings associated with the effectiveness of nonsurgical treatment in patients with adhesive SBO. Multi-detector row CT studies were examined for 159 patients who were initially treated medically.

The researchers found that nonsurgical treatment succeeded and failed in 71 and 29 percent of patients, respectively. An anterior parietal adhesion, a feces sign, and the lack of a beak sign correlated with successful nonsurgical treatment, in univariate analysis, while two or more beak signs, a whirl sign, a C- or U-shaped appearance of the bowel loop, and a high degree of obstruction correlated with nonsurgical treatment failure. Fewer than two beak signs and the presence of an anterior parietal adhesion correlated independently with nonsurgical treatment effectiveness, with odds ratios of 0.27 and 0.11, respectively.

"The number of beak signs and the location of the transition zone in relation to the anterior peritoneal layer are independent signs associated with the success or failure of nonsurgical treatment," the authors write.

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