CT Results May Predict Treatment Effectiveness in Patients with Small-bowel Obstruction

According to a recent study published in the November issue of Radiology, computed tomographic (CT) findings may be able to predict the efficacy of nonsurgical treatment in patients afflicted with adhesive small-bowl obstruction (SBO).

Led by Ingrid Millet, MD, Hôpital Lapeyronie in Montpellier, France, the retrospective study observed CT findings from nonsurgical treatment in patients with adhesive SBO. Multi-detector row CT studies were examined for a total of 159 patients (64 women, 95 men, with a median age of 69 years). Millet and her team compared results according to the success or failure of nonsurgical treatment. They performed univariate statistical analyses for both qualitative and quantitative data. Additionally, each important parameter was included in a multivariate logistic regression analysis.

The researchers reported nonsurgical treatment succeeded in 113 patients (71%) and failed in 46 patients (29%).They had found that at theunivariate analysis, “an anterior parietal adhesion, a feces sign, and the lack of beak sign were associated with successful nonsurgical treatment, whereas 2 beak signs or more, a whirl sign, a C- or U-shaped appearance of the bowel loop, and a high degree of obstruction correlated with nonsurgical treatment failure”.

By contrast, at the multivariate analysis, only “fewer than2 beak signs and the presence of an anterior parietal adhesion correlated independently with nonsurgical treatment effectiveness, with odds ratios of 0.27 and 0.11, respectively”.

According to the study, specifically regardingpatient care, the number of beak signs as well as presence of an anterior parietal adhesion are integral when making significant calls for patients afflicted with SBO without signs of bowel strangulation.

The authors concluded, “The numbers of beak signs and the location of the transition zone in relation to the anterior peritoneal layer are independent signs associated with the success or failure of nonsurgical treatment.”