Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept
Background. To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction. Materials and Methods. We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October...
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| Format: | Article |
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Wiley
2019-01-01
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| Series: | Gastroenterology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/2350948 |
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| author | Federica Vernuccio Dario Picone Gregorio Scerrino Massimo Midiri Giuseppe Lo Re Roberto Lagalla Giuseppe Salvaggio |
| author_facet | Federica Vernuccio Dario Picone Gregorio Scerrino Massimo Midiri Giuseppe Lo Re Roberto Lagalla Giuseppe Salvaggio |
| author_sort | Federica Vernuccio |
| collection | DOAJ |
| description | Background. To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction. Materials and Methods. We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October 2017. Two radiologists evaluated CT scans before and after contrast agent in two reading sessions. Then, we calculated sensitivity of CT in the diagnosis of bowel obstruction and determined in which cases the etiology of bowel obstruction was detected on both unenhanced and enhanced CT or on enhanced CT only. The reference standard was defined as the final diagnosis obtained after surgery. Results. Eighteen patients (mean age 72±15 years, age range 37-88 years) were included in the study. Sensitivity of unenhanced CT and enhanced CT was not significantly different in either small bowel obstruction (64%, 7/11 patients vs. 73%, 8/11 patients; P=0.6547) or large bowel obstruction (71%, 5/7 patients vs. 100%, 7/7 patients; P=0.1410). Adhesions were identified on unenhanced CT as the etiology of small bowel obstruction in 80% (4/5) of patients. Tumors were identified on unenhanced CT as the etiology of large bowel obstruction in 67% (4/6) of patients. Conclusion. In the diagnosis of small bowel obstruction due to adhesions with normal bowel wall thickening and when a neoplasm is identified as the etiology of large bowel obstruction on unenhanced CT, an intravenous contrast agent may be avoided for the identification of the etiology. In remaining cases, contrast agent is still recommended. |
| format | Article |
| id | doaj-art-f896eda54e5e481499f0844e3a5371b1 |
| institution | Kabale University |
| issn | 1687-6121 1687-630X |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
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| series | Gastroenterology Research and Practice |
| spelling | doaj-art-f896eda54e5e481499f0844e3a5371b12025-02-03T06:12:19ZengWileyGastroenterology Research and Practice1687-61211687-630X2019-01-01201910.1155/2019/23509482350948Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of ConceptFederica Vernuccio0Dario Picone1Gregorio Scerrino2Massimo Midiri3Giuseppe Lo Re4Roberto Lagalla5Giuseppe Salvaggio6Department ProMISE (Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties), University Hospital of Palermo, Piazza delle Cliniche, 2, 90127 Palermo, ItalyDepartment of Biopathology and Medical Biotechnologies, University Hospital of Palermo, Via del Vespro 129, 90127 Palermo, ItalyUnit of General and Emergency Surgery, Department of Surgical, Oncological and Oral Sciences, University of Palermo, 90127 Palermo, ItalyDepartment of Biopathology and Medical Biotechnologies, University Hospital of Palermo, Via del Vespro 129, 90127 Palermo, ItalyDepartment of Biopathology and Medical Biotechnologies, University Hospital of Palermo, Via del Vespro 129, 90127 Palermo, ItalyDepartment of Biopathology and Medical Biotechnologies, University Hospital of Palermo, Via del Vespro 129, 90127 Palermo, ItalyDepartment of Biopathology and Medical Biotechnologies, University Hospital of Palermo, Via del Vespro 129, 90127 Palermo, ItalyBackground. To compare sensitivity of unenhanced computed tomography (CT) and contrast-enhanced CT for the identification of the etiology of bowel obstruction. Materials and Methods. We retrospectively evaluated abdominal CT scans of patients operated for bowel obstruction from March 2013 to October 2017. Two radiologists evaluated CT scans before and after contrast agent in two reading sessions. Then, we calculated sensitivity of CT in the diagnosis of bowel obstruction and determined in which cases the etiology of bowel obstruction was detected on both unenhanced and enhanced CT or on enhanced CT only. The reference standard was defined as the final diagnosis obtained after surgery. Results. Eighteen patients (mean age 72±15 years, age range 37-88 years) were included in the study. Sensitivity of unenhanced CT and enhanced CT was not significantly different in either small bowel obstruction (64%, 7/11 patients vs. 73%, 8/11 patients; P=0.6547) or large bowel obstruction (71%, 5/7 patients vs. 100%, 7/7 patients; P=0.1410). Adhesions were identified on unenhanced CT as the etiology of small bowel obstruction in 80% (4/5) of patients. Tumors were identified on unenhanced CT as the etiology of large bowel obstruction in 67% (4/6) of patients. Conclusion. In the diagnosis of small bowel obstruction due to adhesions with normal bowel wall thickening and when a neoplasm is identified as the etiology of large bowel obstruction on unenhanced CT, an intravenous contrast agent may be avoided for the identification of the etiology. In remaining cases, contrast agent is still recommended.http://dx.doi.org/10.1155/2019/2350948 |
| spellingShingle | Federica Vernuccio Dario Picone Gregorio Scerrino Massimo Midiri Giuseppe Lo Re Roberto Lagalla Giuseppe Salvaggio Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept Gastroenterology Research and Practice |
| title | Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept |
| title_full | Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept |
| title_fullStr | Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept |
| title_full_unstemmed | Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept |
| title_short | Intravenous Contrast Agent in Abdominal CT: Is It Really Needed to Identify the Cause of Bowel Obstruction? Proof of Concept |
| title_sort | intravenous contrast agent in abdominal ct is it really needed to identify the cause of bowel obstruction proof of concept |
| url | http://dx.doi.org/10.1155/2019/2350948 |
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