What are the computed tomography (CT) findings in a female with a bowel obstruction?

From the Guidelines

In a CT scan of a female with a bowel obstruction, you would see dilated loops of bowel proximal to the obstruction point and collapsed bowel distal to it, with the transition point between dilated and collapsed segments being a key diagnostic feature, as reported in the most recent study 1. The CT scan would help identify the location of the obstruction, the grade of the obstruction, and may also identify a possible transition zone, which is crucial in determining the management of the patient 1. Some key findings on the CT scan include:

• Dilated loops of bowel proximal to the obstruction point
• Collapsed bowel distal to the obstruction point
• Transition point between dilated and collapsed segments
• Possible "string of pearls" sign, representing small bubbles of gas trapped between fluid in the small bowel
• Fecal material may be visible in the small intestine, which is abnormal
• Thickened bowel wall and fluid between bowel loops indicating inflammation or ischemia
• Cause of obstruction, such as adhesions, hernias, tumors, or foreign bodies, may be visible
• In females, gynecological causes like ovarian masses or complications from endometriosis might be identified
• Signs of bowel perforation, including free air or fluid in the abdominal cavity, may be present
• Vascular compromise to the bowel, appearing as poor enhancement of the bowel wall, may be evaluated The use of water-soluble contrast can optimize the diagnostic value of the CT scan, and X-ray can evaluate the progress of the contrast at 24 h after CT, as recommended in the study 1. The CT scan findings would guide the management of the patient, with findings such as closed-loop obstruction, markers of bowel ischemia, and the "small bowel feces sign" predicting the need for operative management 1. Overall, the CT scan is a crucial diagnostic tool in the management of bowel obstruction, providing valuable information on the location, grade, and cause of the obstruction, as well as potential complications, as reported in the study 1.

From the Research

CT Findings in Bowel Obstruction

The computed tomography (CT) findings in a female with a bowel obstruction may include:

• Dilated small-bowel loops proximal to the suspected site of obstruction and collapsed or normal-appearing loops of small bowel distal to the obstruction 2
• Closed-loop obstruction and bowel dilation, which are characteristic findings of bowel obstruction 3, 4
• Signs of threatened bowel viability, such as ischemia or strangulation 5, 6
• Extraluminal abnormalities, such as abscesses, neoplastic lesions, or peritoneal carcinomatosis, which may be the cause of the obstruction 2

Diagnostic Criteria

The diagnostic criteria for bowel obstruction on CT include:

• Dilated small-bowel loops with a diameter of 2.5 cm or more 2
• Presence of a single transition point or a closed loop 6
• Collapse or normal appearance of small-bowel loops distal to the obstruction 2

Importance of CT in Diagnosis

CT is the diagnostic modality of choice for bowel obstruction, as it can:

• Confirm the presence of obstruction 3, 2
• Determine the cause of obstruction 3, 2
• Identify signs of complications, such as ischemia or strangulation 6
• Provide a comprehensive evaluation of the bowel and surrounding structures 2