Role of Computed Tomography Scan in the Assessment of Subacute Intestinal Obstruction at Bhuj, Kutch: A Prospective Study

Background: Bowel obstruction occurs when the normal flow of intraluminal contents is interrupted. Obstruction can be functional or due to  a mechanical obstruction. Now a day’s CT is considered to be the most efficacious imaging technique for determining the cause of intestinal obstruction. However, the indications for the use of CT in patients with Sub-Acute Intestinal Obstruction (SAIO) have not been fully defined. Objectives of the present study are to study the role of CT in Diagnosis of patients with suspected subacute intestinal obstruction (SAIO), to find out site & cause of obstruction and to diagnose complications of obstruction. Subjects and Methods: This study was conducted at Department of Radiodiagnosis, Gujarat Adani institute of Medcial Science, Bhuj, Kutch, Gujarat. Total number of 22 patients with SAIO having equivocal findings on USG was included in this study. Detailed clinical evaluation of the patients was done. Plain x-ray of abdomen in erect posture & abdominopelvic ultrasound were performed before CT scan. CT scans were performed on a GE lightspeed VCT 64 slice scanner and acquired in precontrast & portovenous phase at 60sec after i.v. contrast administration. Results:  Age of the patients in the study range between 14 to   76 years. Out of 22 were 12 male & 10 female patients. On CT scan all 22 patients were found to have obstruction with 19 patients having mechanical obstruction & 3 patients having pseudo obstruction secondary to appendicitis, jejunal perforation. Most common cause of SAIO was ileal stricture 38% followed by intussusceptions 23%. Conclusion: CT is not only useful in distinguishing mechanical obstruction from paralytic ileus but also it often establishes the cause of obstruction & presence of complications like strangulation & perforation.