Usefulness of US in Adhesive Small-Bowel Obstruction: Comparison with CT

  • Dr Jong Yeol Kim, Department of Radiology, Gumi CHA Hospital, Pochon CHA University College of Medicine, Korea
  • Dr Jae Kwang Lim, Department of Radiology, Kyungpook National University Hospital, Korea
  • Dr Gab Chul Kim, Department of Radiology, Kyungpook National University Hospital, Korea
  • Professor Hun Kyu Ryeom, Department of Radiology, Kyungpook National University Hospital, Korea
  • Dr Hui Joong Lee, Department of Radiology, Kyungpook National University Hospital, Korea

    • Purpose: To evaluate the usefulness of US compared with CT and surgical findings in adhesive small-bowel obstruction (SBO) patients
    Materials and Methods: We retrospectively reviewed US, CT, and surgical findings of 41 patients with surgically proven adhesive SBO (18 male, 23 female; mean age: 52 years). US was evaluated for possibility of undergoing examination; location of transition zone; location, shape, and echo of adhesion. CT and surgical findings were reviewed for location of transition zone; location and shape of adhesion. US and CT findings were compared with surgical findings as reference standard.
    Results: Two of 41 patients underwent limited US examination due to poor sonic window and severe abdominal pain. US detected the transition zone of 39 patients and adhesions of 28 patients. Twenty seven patients showed hypoechoic asymmetrical thickening of bowel wall which were proven fibrotic bands; one patient showed hyperechoic ring-like lesion surrounding the transition zone, which proven an omental band. CT detected the transition zone of 32 patients and adhesions of 11 patients. Adhesions were identified as thickening of bowel wall (n = 8), perienteric infiltrations (n = 8), and adjacent peritoneal thickening (n = 8) on CT. Diagnostic accuracy of US and CT for detecting the transition zone were 90.7% and 75%. Detection rate of US and CT for adhesions were 68.3% (28/41) and 26.8% (11/41).
    Conclusion: US may be a useful modality for detecting transition zone and adhesions of adhesive SBO, especially when CT findings are equivocal.