Role of multi-slice computed tomography in evaluation and management of intestinal obstruction

Background: The purpose of this study is to evaluate the role of multi-slice computed tomography (CT) with reference to presence or absence of intestinal obstruction, level of obstruction, the cause of obstruction, and correlating with their clinical diagnosis.Methods: Patients were admitted directly from Out Patient Department or emergency department with complaints suggestive of intestinal obstruction. Computed tomography scan interpretations performed by experienced radiologists were compared with the final diagnosis that was made on the basis of information obtained clinically, by investigations, and by surgical findings.Results: Majority of patients were males 62%. Mean age 51.62±17.46 years. Majority presents with abdominal pain 94% and constipation 72%.The most common cause of obstruction was adhesion bands 18%.The pre CT diagnosis was changed because of CT findings in 28 patients. Only in 50 (89.28%) patients CT findings matched with intra-operative and cause of obstruction was also found, and in 6 (10.71%) patients intra-operative findings are different from CT findings. In bowel obstruction, the CT sensitivity was 89.28%, specificity 90.90%, positive predictive value 92.59%, negative predictive value 86.95% and accuracy 92.59%.Conclusions: We concluded that multi-slice CT is highly sensitive and specific in determining the presence, the cause and site of bowel obstruction, the site of obstruction and cause of obstruction. We recommended the use of CT scan when diagnosis between ileus and obstruction on the basis of clinical and plain radiographic are difficult or in patients in whome small bowel obstruction is diagnosed when conservative management is contemplated.

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Clinical study on role of CECT abdomen in intestinal obstruction

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20191296 ◽

2019 ◽

Vol 7 (4) ◽

pp. 967 ◽

Cited By ~ 1

Author(s):

Bhavesh V. Vaishnani ◽

Mohammad Farooque G. Dudhwala

Keyword(s):

Intestinal Obstruction ◽

Ct Scan ◽

Bowel Obstruction ◽

Clinical Laboratory ◽

Helical Ct ◽

Final Diagnosis ◽

Large Bowel Obstruction ◽

Ct Findings ◽

Contrast Enhanced

Background: Intestinal obstruction is a common clinical occurrence and can be either dynamic or adynamic. The old saying “Never let the sun set or rise on an obstructed bowel” taught to minimize missing strangulation. Helical CT with its multiplanar reformatted imaging can accurately characterize the level, degree, cause and associated complications of obstruction. Aim of the study was to depict the spectrum of MDCT findings in cases of small and large bowel obstruction and correlation of CT scan with intraoperative findings and the cause of intestinal obstruction.Methods: Contrast enhanced MDCT examination of 50 patients were prospectively included in the study who had evidence of clinical as well as MDCT evidence of bowel obstruction and in whom surgical/clinical follow-up for final diagnosis was available. CT scan was done in all the patients with MDCT (Brightspeed GE 16 slice system). The axial sections were reconstructed in coronal and saggital planes to determine site and cause of bowel obstruction.Results: The commonest cause of intestinal obstruction in adults in this study series was adhesions/bands in 38% cases. Out of 47 operated patients for intestinal obstruction, CT findings matched with intraoperative findings in 43 patients (91%) whereas cause of intestinal obstruction matched with CT findings in 37 patients (74%).Conclusions: Management decisions in intestinal obstruction remain notoriously difficult, relying on a combination of clinical, laboratory, and imaging factors to help stratify patients into conservative or surgical treatment. CT in these patients can help surgeon to go for surgery early and prevent complications.

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Role of high-resolution computed tomography scan in the evaluation of cholesteatoma: A correlation of high-resolution computed tomography with intra-operative findings

Indian Journal of Otology ◽

10.4103/0971-7749.155294 ◽

2015 ◽

Vol 21 (2) ◽

pp. 103 ◽

Cited By ~ 3

Author(s):

AshishChandra Agarwal ◽

R Balakrishnan ◽

Kailesh Pujary ◽

Sandeep Sreedhar

Keyword(s):

Computed Tomography ◽

High Resolution ◽

Computed Tomography Scan ◽

High Resolution Computed Tomography ◽

Operative Findings ◽

Tomography Scan

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Role of multidetector computed tomography in evaluation of abdominal trauma in Sothern Rajasthan, India

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20192526 ◽

2019 ◽

Vol 7 (6) ◽

pp. 2350

Author(s):

Puran . ◽

Narendra Kumar Kardam

Keyword(s):

Computed Tomography ◽

Multidetector Computed Tomography ◽

Abdominal Trauma ◽

Imaging Modality ◽

Abdominal Injury ◽

Male Predominance ◽

Ct Findings ◽

Highly Sensitive

Background: Abdominal injury constitutes a significant portion of all blunt and penetrating body injuries. Computed tomography is an important and fast technique which gives rapid information on the type of abdominal injury and helps in management of the patient accordingly. The aim of the present study was to evaluate the usefulness of Multidetector Computed Tomography (MDCT) in detection of intra-abdominal injury in patients with blunt abdominal trauma and to provide information that could accurately determine choice of management (non- operative versus operative). And to correlate the computed tomography (CT) findings with either clinical observation, follow up CT scan (if required) or surgical findings (wherever applicable).Methods: A total of 50 patients with abdominal trauma who underwent computed tomography (CT) examination were included. CT findings were compared with surgical findings in operated cases, and in the rest CT findings were compared by clinical outcome.Results: Among the 50 cases studied, all 50 had positive CT findings of abdominal trauma, out of which 24 patients underwent surgery and the remaining were managed conservatively. The age group of the patients was ranging from 8 to 66 years with male predominance. In this study the commonest organs affected were liver and spleen accounting for 48% and 44% respectively.Conclusions: Computed tomography is an important and highly sensitive imaging modality for diagnosis of organ injuries in patients with abdominal trauma and accordingly deciding the management of patient.

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Role of high-resolution ultrasound in the assessment of abdominal wall masses and mass-like lesions

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-019-0027-6 ◽

2019 ◽

Vol 50 (1) ◽

Cited By ~ 1

Author(s):

Ahmed Abdelrahman Mohamed Baz ◽

Hatem Mohamed Said El-Azizi ◽

Mohamed Sayed Qayati Mohamed ◽

Ahmed Yehia Ibrahim Abdeldayem

Keyword(s):

High Resolution ◽

Abdominal Wall ◽

Predictive Value ◽

Ultrasound Examination ◽

Ct Findings ◽

Operative Findings ◽

A Prospective Study ◽

Histopathological Results ◽

Contrast Media Administration

Abstract Background To evaluate the diagnostic accuracy of high-resolution ultrasound in the assessment of abdominal wall masses and mass-like lesions and to provide an overview of the sonographic appearances of different abdominal wall pathologies, 54 patients were included in a prospective study. The patients’ age was ranging from 1 to 75 years. Twenty-eight were females (51.9%) and 26 were males (48.1%); all were evaluated by a high-resolution ultrasound examination, and the results were correlated to the patients’ operative findings and histopathological results as well as the pelviabdominal CT findings. Results In comparison to the operative, histopathological, and CT findings, the high-resolution ultrasound had an overall 100% accuracy for abdominal wall lesions, and for hernia cases, it had 100% sensitivity, 100% specificity, 100% accuracy, 100% positive predictive value, and 100% negative predictive value. Conclusion The current study had encouraging results regarding the role of high-resolution ultrasound in the assessment of abdominal wall masses and mass-like lesions; nevertheless, it is considered as an effective and simple diagnostic tool that may limit the patients’ exposure to invasive biopsies and to the hazardous exposure to ionizing radiation and contrast media administration like that in CT examination.

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Role of Computed Tomography Scan in The Evaluation of Cerebral Palsy in Children

KYAMC Journal ◽

10.3329/kyamcj.v11i1.47143 ◽

2020 ◽

Vol 11 (1) ◽

pp. 3-8

Author(s):

Momotaj Begum ◽

Sabina Yiasmeen ◽

Mahmud Hossain ◽

Shafi Ahmed ◽

Salahuddin Al Azad ◽

...

Keyword(s):

Computed Tomography ◽

Cerebral Palsy ◽

Ct Scan ◽

Predictive Value ◽

Cross Sectional Study ◽

Sectional Study ◽

Computed Tomography Scan ◽

Cross Sectional ◽

Tomography Scan

Background. Cerebral palsy is one of the common childhood neurological problem which occurs due to defect or lesion in immature brain. The worldwide incidence of cerebral palsy is approximately 2-2.5 per 1000 live births. There have been many works on the role of computed tomography scan in the diagnosis of cerebral palsy. Objective: The objective information available from careful review of imaging information such as CT brain scans, is an important adjunct to clinical data. Materials and Methods: This cross sectional study was carried out in the department of Radiology and Imaging, BSMMU and department of Paediatric Neurology unit over a period of 12 months from January 2019 to December 2019. We calculated the sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CT scan in diagnosis of CP in children. Results: This cross sectional study was carried out on consecutively selected 94 children below 15 years having clinical evidence of cerebral palsy. Among the study subjects 86.2% were diagnosed as cerebral palsy through CT scan. Conclusion: The sensitivity and specificity of CT scan of present study was found to be quite high in children which suggests a CT scan as an effective investigation for the diagnosis of cerebral palsy. KYAMC Journal Vol. 11, No.-1, April 2020, Page 3-8

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The Role of Diagnostic Nasal Endoscopy and a Computed Tomography Scan (Nose and PNS) in the Assessment of Chronic Rhinosinusitis: A Comparative Evaluation of the Two Techniques

Sinusitis ◽

10.3390/sinusitis5010007 ◽

2021 ◽

Vol 5 (1) ◽

pp. 59-66

Author(s):

Karthika Nathan ◽

Sudhir Kumar Majhi ◽

Rohit Bhardwaj ◽

Ankur Gupta ◽

Sabarirajan Ponnusamy ◽

...

Keyword(s):

Computed Tomography ◽

Chronic Rhinosinusitis ◽

Diagnostic Tool ◽

Predictive Value ◽

Cost Effective ◽

Nasal Endoscopy ◽

Symptom Criteria ◽

Tomography Scan

Introduction: The objective components of chronic rhinosinusitis (CRS) diagnosis require confirmatory findings from either diagnostic nasal endoscopy (DNE) or a computed tomography (CT) scan. Chronic rhinosinusitis affects a significant population worldwide, imposing a huge toll on the human economy as well as on quality of life. Thus, it is particularly important to define a cost-effective and easily available diagnostic tool for it. Hence, we have conducted this study with the aim of assessing the effectiveness of DNE in comparison with CT for evaluating CRS. Material and Methods: Eighty participants fulfilling the diagnostic symptom criteria of CRS underwent CTs of their noses and paranasal sinuses (PNS) and DNE. Standard Lund–Mackay and Lund–Kennedy scores were awarded to all participants based on the CT and DNE. A comparative analysis was done. Results: DNE in comparison to CT had 92.31% sensitivity, 73.33% specificity, 93.75% positive predictive value, 68.75% negative predictive value, and 88.75% diagnostic accuracy. Conclusion: We suggest that nasal endoscopy be used as an early diagnostic tool in the clinical assessment of suspected CRS patients (based on the diagnostic symptom criteria). DNE helps to decrease the usage of CT, thereby decreasing cost and radiation exposure. Computed tomography may be added for patients having anatomical defects (affecting endoscopic visualization) or refractory disease, and where surgery has been planned.

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Role of Computed Tomography in evaluation of Proptosis

Nepal Journal of Medical Sciences ◽

10.3126/njms.v2i1.7649 ◽

2013 ◽

Vol 2 (1) ◽

pp. 34-37 ◽

Cited By ~ 1

Author(s):

P Sharma ◽

PK Tiwari ◽

PG Ghimire ◽

P Ghimire

Keyword(s):

Computed Tomography ◽

Cost Effective ◽

Final Diagnosis ◽

Medical Sciences ◽

Effective Technique ◽

Common Cause ◽

Cost Effective Technique ◽

History Of ◽

Operative Findings

Background: To analyze the role of Computed Tomography in the evaluation of proptosis. Methods: It is a retrospective review of 30 patients with the history of proptosis who were referred to the department of radiology and imaging for computed tomography of orbit. Computed tomography of orbits was evaluated to assess the nature and extension of the lesion. Final diagnosis was made based on the histopathology, operative findings and clinical outcome. Statistical analysis was carried out with the help of SPSS - 17 to find the accuracy of Computed Tomography. Results: Thirty patients ranging from three to 73 years were included in the study. Mean age was 35.4±19.6 years. Male:Female ratio was 2:1. Most common cause of proptosis was inflammation (47%) followed by tumor. Among the inflammatory causes pseudotumor was the most common type. Other causes of proptosis include tumor (37%), Vascular (10%), Infection (3%) and Trauma (3%). Accuracy of Computed Tomography in the diagnosis of etiology of proptosis was 86.6%. Conclusion: Computed tomography is the simple, cost effective technique in the evaluation of proptosis with the accuracy of 86.6%. Inflammation was the most common cause of proptosis. Nepal Journal of Medical Sciences | Volume 02 | Number 01 | Jan-Jun 2013 | Page 34-37 DOI: http://dx.doi.org/10.3126/njms.v2i1.7649

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Endometriosis Mimicking a Cecum Mass with Complete Bowel Obstruction: An Infrequent Cause of Acute Abdomen

Case Reports in Surgery ◽

10.1155/2019/7024172 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Gabriel A. Molina ◽

Darwin R. Ramos ◽

Alberto Yu ◽

Patricio A. Paute ◽

Paul S. Llerena ◽

...

Keyword(s):

Intestinal Obstruction ◽

Bowel Obstruction ◽

Preoperative Diagnosis ◽

Malignant Tumors ◽

Signs And Symptoms ◽

Final Diagnosis ◽

Intestinal Involvement ◽

History Of ◽

Ovarian Abscess ◽

Fertile Women

Endometriosis is a common entity among fertile women which unfortunately manifests through variable symptomatology. Intestinal involvement in endometriosis is quite common and can simulate several diseases such as Crohn’s disease, appendicitis, tubo-ovarian abscess, or malignant tumors. Intestinal obstruction due to endometriosis is rare, and preoperative diagnosis is difficult because the signs and symptoms are nonspecific and can be easily confused. In the case of patients without a history of endometriosis, diagnosis is further complicated. We present a case of a 41-year-old female patient. She presented to the emergency room with complete bowel obstruction and a mass in the cecum. Surgery was decided, and the patient underwent full recovery. Endometriosis was the final diagnosis for the observed condition.

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Surgeon-performed Ultrasound for Primary Hyperparathyroidism

The American Surgeon ◽

10.1177/000313481307900711 ◽

2013 ◽

Vol 79 (7) ◽

pp. 681-685 ◽

Cited By ~ 6

Author(s):

Worthington G. Schenk ◽

John B. Hanks ◽

Philip W. Smith

Keyword(s):

Primary Hyperparathyroidism ◽

Class 1 ◽

Additional Imaging ◽

Surgical Cure ◽

Operative Findings ◽

Enhanced Computed Tomography ◽

High Degree ◽

Tomography Scan ◽

Parathyroid Imaging

The role of preoperative parathyroid imaging continues to evolve. This study evaluated whether surgeon-performed ultrasound (U/S) obviates the need for other imaging studies and leads to a focused exploration with a high degree of surgical success. From July 2010 to February 2012, 200 patients presenting with nonfamilial primary hyperparathyroidism underwent neck U/S in the surgeon's office. The U/S interpretation was classified as Class 1 if an adenoma was identified with high confidence, Class 2 if a possible but not definite enlarged gland was imaged, and Class 0 (zero) if no adenoma was identified. The findings were correlated with subsequent intra-operative findings. There were 144 Class 1 U/Ss (72%); of 132 patients coming to surgery, 96.2 per cent had surgical findings concordant with preoperative U/S and all had apparent surgical cure. Twenty-nine patients (14.5%) had Class 2 U/S; the 31 per cent confirmed false-positives in this group were usually colloid nodules. Fourteen of 27 with Class 0 U/S underwent surgery after being offered dynamically enhanced computed tomography scan. All 200 patients were apparent surgical cures. Surgeon-performed U/S is expedient, convenient, inexpensive, and accurate. A clearly identified adenoma can safely lead to a focused limited exploration and avoid additional imaging 93 per cent of the time.

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