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Bowel obstruction is one of the commonest causes of acute abdomen and emergency surgical admissions. Ultrasonography and abdominal radiography can diagnose bowel obstruction and perforation by revealing dilated intestinal loops and abnormal air-fluid levels in cases of obstruction and extra-luminal air in perforation. However, the exact etiology, site of obstruction and associated complications cannot be properly assessed. The commonest causes of intestinal obstruction are adhesions, external hernias and neoplasms. However, infrequently bowel may get obstructed due to internal hernia, volvulus and encapsulating peritonitis. CT is the most valuable imaging technique for identifying the presence, site and cause of the GI tract perforation. MDCT, by virtue of its excellent multiplanar capabilities & demonstration of exact anatomical relationships comes to the rescue of radiologists in these grave clinical scenarios. Study aimed at recognizing the imaging features of intestinal obstruction and perforation. Identification of rare causes of bowel obstruction like internal hernia, abdominal cocoon and volvulus. Assessment of associated complications and differentiation of benign from malignant causes of intestinal obstruction. Material and methods: This was a prospective study done in the department of Radio diagnosis, Rohilkhand medical college and hospital, Bareilly over a period of two years from July 2017 to June 2019. Results: The most common cause of obstruction in our study was adhesions followed by external hernias while uncommon causes included volvulus and internal hernias. Majority of gastrointestinal perforations were caused by malignant neoplasms and spontaneous perforations. Conclusion: MDCT can reliably identify intestinal obstruction and perforation and diagnose its etiology. It holds special importance in identification of rare causes of bowel obstruction such as internal hernia, volvulus and abdominal cocoon. Also, MDCT can reliably identify the site of perforation.

From Bowel Obstruction to Perforation: Role of CT as a Troubleshooter Imaging Modality