Bowel obstruction CT

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Hadeel Maksoud M.D.[2]

Abdominal CT scan may be helpful in the diagnosis of bowel obstruction. Findings on CT scan suggestive of bowel obstruction include dilated bowel loops with air-fluid level, distal collapsed bowel, in addition to, “Target”, “Whirl” and “Venous cut-off” signs.

• Abdominal CT scan may be helpful in the diagnosis of bowel obstruction. Findings on CT scan suggestive of bowel obstruction include:^{[1][2][3][4][5]}
  • Dilated bowel loops with air-fluid level
  • Distal collapsed bowel
    • Additional signs:
      • “Target sign” – indicates intussusception
      • “Whirl sign” – indicates volvulus
      • “Venous cut-off sign” – indicates thrombosis
      • Ascites
      • Edema of the mesentery and submucosal edema
      • Hemorrhage
      • Bowel wall thickness exceeding 3mm

• CT scan can determine the following over plain X-ray:
  • Specific site of obstruction
  • Severity of obstruction
    • Complete or partial
  • Etiology
    • Such as a hernia or mass or inflammations
  • Complications
    • Such as ischemia, necrosis, and perforations

• It is recommended to perform an X-ray first, especially if intervention is needed immediately, since X-rays are readily available, afford less radiation to the patient and are more cost effective.
• However, CT scan is more effective at determining those cases that need surgical intervention and can provide more surgical detail.

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