Evidence-based Diagnosis of Small Bowel Obstruction with Computed Tomography_Chinese Journal of Evidence-Based Medicine

Authors：

LI Zhengyan ¹ , WU Bing ¹ , ZHANG Ling ² ,  WU Hongmei ²

1. Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China2 Department of Geriatrics, West China Hospital, Sichuan University, Chengdu 610041, China;

Corresponding author：

WU Hongmei, Email: drwhm@163.com

Keywords：

Small bowel obstruction; Computed tomography (CT); Diagnosis

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Objective 　We sought a good understanding of the current role of computed tomography (CT) in the diagnosis of small bowel obstruction (SBO).
Methods 　We looked for the best evidence on computed tomography for diagnosing small bowel obstruction by searching MEDLINE/PubMed (1978-April, 2006), SUMsearch (1978-April, 2006), CNKI (1978-April, 2006) and critically appraised the evidence.
Results 　There was powerful evidence supporting the efficacy of computed tomography in the diagnosis of small bowel obstruction. Given the current evidence together with our clinical experience and considering the patient and his family members, values and preferences, computed tomography was done. We confirmed the diagnosis of strangulating small bowel obstruction, which needed immediate operation.
Conclusions 　Computed tomography is a very useful tool for the diagnosis of small bowel obstruction with high sensibility and specificity.

Citation： LI Zhengyan,WU Bing,ZHANG Ling,WU Hongmei. Evidence-based Diagnosis of Small Bowel Obstruction with Computed Tomography. Chinese Journal of Evidence-Based Medicine, 2007, 07(4): 311-315. doi: Copy

1.	GAO YT, MING B, LI ZX, et al. The Value of CT in the Diagnosis and Management of Patients with Acute Small-Bowel Obstruction. J Pract Radiol, 2004, 20(4): 78-79.
2.	Shrake PD, Rex DK, Lappas JC, et al. Radiographic evaluation of suspected small bowel obstruction. Am J Gastroenterol, 1991, 86(16): 175-178.
3.	Guyatt GH, Rennie D, Editors, The Evidence-Based Medicine Working Group. Users, Guides to the Medical Literature: A Mannual for Evidence-Based Clinical Practice. Chicago: AMA Press. 2002.
4.	Phillips B, Ball C, Sackett D, et al. Levels of evidence and grades of recommendation. Available for URL:http://www.cebm.net.
5.	Mallo RD, Salem L, Lalani T, et al. Computed tomography diagnosis of ischemia and complete obstruction in small bowel obstruction: a systematic review. J Gastrointest Surg, 2005, 9(24): 690-694.
6.	Megibow AJ, Balthazar EJ, Cho KC, et al. Bowel obstruction: evaluation with CT. Radiology, 1991, 180(160): 313-318.
7.	Fukuya T, Hawes DR, Lu CC, et al. CT diagnosis of small-bowel obstruction: efficacy in 60 patients. AJR Am J Roentgenol, 1992, 158(278): 765-769; discussion 771-772.
8.	Maglinte DD, Gage SN, Harmon BH, et al. Obstruction of the small intestine: accuracy and role of CT in diagnosis. Radiology, 1993, 188(322): 61-64.
9.	Frager D, Medwid SW, Baer JW, et al. CT of small-bowel obstruction: value in establishing the diagnosis and determining the degree and cause. AJR Am J Roentgenol, 1994, 162(169): 37-41.
10.	Taourel PG, Fabre JM, Pradel JA, et al. Value of CT in the diagnosis and management of patients with suspected acute small-bowel obstruction. AJR Am J Roentgenol, 1995, 165(420): 1187-1192.
11.	Maglinte DD, Reyes BL, Harmon BH, et al. Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction. AJR Am J Roentgenol, 1996, 167(538): 1451-1455.
12.	Makanjuola D. Computed tomography compared with small bowel enema in clinically equivocal intestinal obstruction. Clin Radiol, 1998,53(69): 203-208.
13.	Daneshmand S, Hedley CG, Stain SC. The utility and reliability of computed tomography scan in the diagnosis of small bowel obstruction. Am Surg, 1999, 65(78): 922-926.
14.	Obuz F, Terzi C, Sokmen S, et al. The efficacy of helical CT in the diagnosis of small bowel obstruction. Eur J Radiol, 2003, 48(235): 299-304.
15.	Jaffe TA, Martin LC, Thomas J, et al. Small-bowel obstruction: coronal reformations from isotropic voxels at 16-section multi-detector row CT. Radiology, 2006, 238(1239): 135-142.
16.	高源统, 明兵, 李振勋, 等. CT在急性小肠梗阻病因诊断和处理中的价值，实用放射学杂志，2004, 20(4): 78-79.

1. GAO YT, MING B, LI ZX, et al. The Value of CT in the Diagnosis and Management of Patients with Acute Small-Bowel Obstruction. J Pract Radiol, 2004, 20(4): 78-79.
2. Shrake PD, Rex DK, Lappas JC, et al. Radiographic evaluation of suspected small bowel obstruction. Am J Gastroenterol, 1991, 86(16): 175-178.
3. Guyatt GH, Rennie D, Editors, The Evidence-Based Medicine Working Group. Users, Guides to the Medical Literature: A Mannual for Evidence-Based Clinical Practice. Chicago: AMA Press. 2002.
4. Phillips B, Ball C, Sackett D, et al. Levels of evidence and grades of recommendation. Available for URL:http://www.cebm.net.
5. Mallo RD, Salem L, Lalani T, et al. Computed tomography diagnosis of ischemia and complete obstruction in small bowel obstruction: a systematic review. J Gastrointest Surg, 2005, 9(24): 690-694.
6. Megibow AJ, Balthazar EJ, Cho KC, et al. Bowel obstruction: evaluation with CT. Radiology, 1991, 180(160): 313-318.
7. Fukuya T, Hawes DR, Lu CC, et al. CT diagnosis of small-bowel obstruction: efficacy in 60 patients. AJR Am J Roentgenol, 1992, 158(278): 765-769; discussion 771-772.
8. Maglinte DD, Gage SN, Harmon BH, et al. Obstruction of the small intestine: accuracy and role of CT in diagnosis. Radiology, 1993, 188(322): 61-64.
9. Frager D, Medwid SW, Baer JW, et al. CT of small-bowel obstruction: value in establishing the diagnosis and determining the degree and cause. AJR Am J Roentgenol, 1994, 162(169): 37-41.
10. Taourel PG, Fabre JM, Pradel JA, et al. Value of CT in the diagnosis and management of patients with suspected acute small-bowel obstruction. AJR Am J Roentgenol, 1995, 165(420): 1187-1192.
11. Maglinte DD, Reyes BL, Harmon BH, et al. Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction. AJR Am J Roentgenol, 1996, 167(538): 1451-1455.
12. Makanjuola D. Computed tomography compared with small bowel enema in clinically equivocal intestinal obstruction. Clin Radiol, 1998,53(69): 203-208.
13. Daneshmand S, Hedley CG, Stain SC. The utility and reliability of computed tomography scan in the diagnosis of small bowel obstruction. Am Surg, 1999, 65(78): 922-926.
14. Obuz F, Terzi C, Sokmen S, et al. The efficacy of helical CT in the diagnosis of small bowel obstruction. Eur J Radiol, 2003, 48(235): 299-304.
15. Jaffe TA, Martin LC, Thomas J, et al. Small-bowel obstruction: coronal reformations from isotropic voxels at 16-section multi-detector row CT. Radiology, 2006, 238(1239): 135-142.
16. 高源统, 明兵, 李振勋, 等. CT在急性小肠梗阻病因诊断和处理中的价值，实用放射学杂志，2004, 20(4): 78-79.

Chinese Journal of Evidence-Based Medicine

Evidence-based Diagnosis of Small Bowel Obstruction with Computed Tomography

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