E2062. How to Differentiate Between Flange Occlusions and Adhesion Occlusions in a CT Scan?
  1. Christ Gakosso; University Cadi Ayyad
Determine CT scans to differentiate between flange occlusions and adhesion occlusions and develop a predictive score for flange occlusion.

Materials and Methods:
Patients who underwent flange or adhesion occlusion surgery between January 2018 and June 2020 were included retrospectively. The reference diagnosis was surgical. All scans were secondarily reviewed blindly from the surgical diagnosis. The score was constructed on 143 patients and then validated on 50 patients from the same population.

Of the 193 patients operated on, 119 had a flange occlusion. In multivariate analysis, the presence of a beak sign (OR=3.47, 95% CI [1.26;9.53], p=0.02), a closed handle (OR=11.37, 95% CI [1.84;70.39], p=0.009), focal mesentery infiltration (OR=3.71, 95% CI [1.33;10.34], p=0. 01) and focal or diffuse liquid intraperitoneal effusion (respectively OR=4.30, IC95% [1.45;12.73], p=0.009 and OR=6.34, IC95% [1.77;22.59], p=0.004) were significantly associated with the flange mechanism. The presence of a diffuse mesenteric effusion and the diameter of the most dilated loop were inversely associated with the flange mechanism (OR=0.23, IC95% [0.06;0.92], p=0.04 and OR=0.94, IC95% [0.90;0.99], p=0.02 respectively). From these parameters, a score predicted the flange mechanism with an area under the ROC curve of 0.8274.

A digestive emergency that may affect the vital prognosis. Several variables strongly associated with the flange mechanism allow the construction of a prognostic score that could represent a surgical decision support tool.