E1387. Challenges in Diagnosis of Acute Intestinal Obstruction: What to Look for and When to Worry!
Emergency Clinical County Hospital of Cluj-Napoca; Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science and Technology of Târgu Mures
Emergency Clinical County Hospital of Cluj-Napoca
Emergency Hospital Prof. Dr. N. Oblu
Intestinal obstruction is a common clinical syndrome for which effective treatment depends on a rapid and accurate diagnosis. A challenge in clinical management includes clinical presentation, patient history, physical examination findings, laboratory tests, and imaging examinations findings that will help the clinician determine the best therapeutic approach. When an intestinal obstruction is accompanied by signs of strangulation, emergent surgical treatment is advised.
Educational Goals / Teaching Points
This educational exhibit will describe the role of imaging in the diagnosis of acute intestinal obstruction, reviewing the main radiological findings in multidetector CT (MDCT). We will illustrate the main etiologies, complications, and pitfalls through a case-based review.
Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The radiologist plays a critical role in assisting the therapeutic decision of the surgeon by addressing the following questions. Is the intestine obstructed? How severe is the obstruction, where is it located, and what is its cause? Is strangulation present? Therefore, a full understanding of which imaging modalities to use, and what imaging findings to look for is of paramount importance. The most frequent causes are adherences and hernias, but it is important to know other causes of intestinal obstruction. Performing an adequate radiological report, correctly identifying complications that may present and the type of obstruction, will make easier patient’s treatment.
Acute intestinal obstruction is a common presentation for which safe and effective management depends on rapid and accurate diagnosis. MDCT is an effective method not only in diagnosing the presence of acute intestinal obstruction but also allows for differential diagnosis of its type depending on the etiological factor, level of obstruction, and degree of compensation.