E2632. Navigating the Twists and Turns: A Case-Based Review of Common and Uncommon Causes of Bowel Obstruction?
  1. Kevin Mason; University of Cincinnati
  2. Kyle Wenker; University of Cincinnati
  3. Juliana Tobler; University of Cincinnati
  4. Shaun Wahab; University of Cincinnati
Bowel obstructions are a frequent etiology for abdominal pain that requires management by a surgical service in most cases. Small bowel obstructions (SBO) account for ~80% of all cases of bowel obstruction. Complicating factors include bowel ischemia and necrosis, metabolic abnormalities, and even death in the setting of delayed treatment. Fibrous adhesions and hernias account for most small bowel obstructions (SBO), while colon cancer is the prevailing culprit of large bowel obstructions (LBO) in developed nations. CT is the primary imaging modality utilized to assess an acute abdomen and allows radiologists to recognize the presence or absence of obstruction on imaging, identify inciting factors, and describe potential complications. Accurate and detailed reporting is imperative for swift clinical decision-making and prompt intervention. This exhibit focuses on the CT findings of small bowel and colonic obstructions due to various etiologies by reviewing unique cases at our institution.

Educational Goals / Teaching Points
The educational goals of this exhibit will be to review the pertinent imaging findings of bowel obstruction including “classic” signs. We will discuss the various etiologies of bowel obstructions including adhesions, foreign bodies, intussusception, volvulus, malignancy, internal and abdominal wall hernias, and congenital and iatrogenic causes. Secondary complications, as well as conservative and surgical treatments utilized at our institution, will also be summarized.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
CT is the primary imaging modality used to detect bowel obstructions. Familiarity with various etiologies of bowel obstruction and bowel anatomy will assist diagnosis. Recognizing complications of bowel obstruction, such as ischemia, infarction, and perforation, is critical to expedite care and triage patients into the appropriate treatment algorithm.

Bowel obstructions represent one of the most common etiologies of abdominal pain in radiology. Prompt recognition and identification of the etiology and severity allows for timely management and improved patient care.