From the Guidelines
Stasis on an abdominal CT scan refers to the abnormal retention or slowing of contents within the digestive tract, indicating a potential obstruction or motility issue that requires further evaluation and management to prevent complications such as bacterial overgrowth, aspiration, or perforation. This finding is significant in the context of bowel obstruction, ileus, gastroparesis, or severe constipation, where the normal movement of food, fluid, or stool through the gastrointestinal system is impaired. The diagnosis of stasis is often facilitated by CT scans, which, as noted in the 2017 WSES guidelines on colon and rectal cancer emergencies 1, achieve diagnostic confirmation better than abdominal ultrasound or plain X-ray in cases of suspected colon obstruction.
When interpreting CT scans for stasis, it's crucial to consider the location and severity of the finding, as this information helps determine the underlying cause and guides further management. The 2017 WSES guidelines also emphasize the importance of CT scans in staging colorectal cancer emergencies, highlighting their superiority over ultrasound in providing detailed information about the abdomen 1. However, the decision to perform a CT scan should always consider the patient's safety and the potential risks versus benefits, especially in emergency situations where time is critical.
In terms of management, the approach to stasis depends on the underlying cause. For example, bowel obstruction may require surgical intervention, while gastroparesis might be managed with medications like metoclopramide to promote gut motility. The choice of treatment should be guided by the severity of symptoms, the patient's overall health status, and the presence of any complications. Given the potential for serious complications associated with prolonged stasis, such as malnutrition, aspiration, or perforation, prompt and appropriate management is essential to improve outcomes and quality of life for patients.
From the Research
Definition of Stasis on Abdominal CT Scan
- Stasis on an abdominal Computed Tomography (CT) scan refers to a condition where there is a lack of movement or flow of intestinal contents, often indicating a bowel obstruction 2.
- In the context of small bowel obstruction, stasis can be identified by the presence of dilated bowel loops and air-fluid levels on the CT scan 3, 4.
CT Scan Findings Indicative of Stasis
- The presence of a transition point, which is the area where the bowel lumen changes from being dilated to normal or collapsed, is a key finding in diagnosing small bowel obstruction and stasis 3, 5.
- Other CT findings that may indicate stasis include the small bowel feces sign, which is characterized by the presence of intraluminal particulate matter in a dilated small bowel, and mesenteric stranding 5.
- The degree of obstruction, including low-grade partial, high-grade partial, and complete obstruction, can also be assessed on CT scans and may be indicative of stasis 5.
Diagnostic Performance of CT Scans in Detecting Stasis
- CT scans have been shown to have a high sensitivity (78%-100%) for detecting complete or high-grade small bowel obstruction, which is often associated with stasis 2, 4.
- However, the diagnostic performance of CT scans may be lower for incomplete obstruction, and adjunct enteroclysis may be necessary in such cases 4.
- The use of multiplanar reformatted imaging and thin sections can help improve the diagnostic accuracy of CT scans in detecting stasis and small bowel obstruction 2, 4.