Real-world accuracy of computed tomography in patients admitted with small bowel obstruction: a multicentre prospective cohort study.

Autor: Nielsen LBJ; Abdominalcenter K, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark., Ærenlund MP; Department of Gastrointestinal and Hepatic Diseases, Surgical Division, Copenhagen University Hospital - Herlev and Gentofte Hospital, Copenhagen, Denmark., Alouda M; Department of Gastrointestinal and Hepatic Diseases, Surgical Division, Copenhagen University Hospital - Herlev and Gentofte Hospital, Copenhagen, Denmark., Azzam M; Department of Surgery, Slagelse Hospital, Slagelse, Denmark., Bjerke T; Abdominalcenter K, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark., Burcharth J; Department of Gastrointestinal and Hepatic Diseases, Surgical Division, Copenhagen University Hospital - Herlev and Gentofte Hospital, Copenhagen, Denmark., Dibbern CB; Department of Surgery, Nordsjællands Hospital, University of Copenhagen, Copenhagen, Denmark., Jensen TK; Department of Gastrointestinal and Hepatic Diseases, Surgical Division, Copenhagen University Hospital - Herlev and Gentofte Hospital, Copenhagen, Denmark., Jordhøj JQ; Department of Surgery, Slagelse Hospital, Slagelse, Denmark., Lolle I; Department of Surgery, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark., Malik T; Department of Surgery, Slagelse Hospital, Slagelse, Denmark., Ngo-Stuyt L; Department of Surgery, Zealand University Hospital, Koge, Denmark., Nielsen EØ; Department of Surgery, Hvidovre Hospital, University of Copenhagen, Copenhagen, Denmark., Olausson M; Department of Surgery, Zealand University Hospital, Koge, Denmark., Skovsen AP; Department of Surgery, Nordsjællands Hospital, University of Copenhagen, Copenhagen, Denmark., Tolver MA; Department of Surgery, Zealand University Hospital, Koge, Denmark., Smith HG; Abdominalcenter K, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400, Copenhagen, Denmark. henry.george.smith@regionh.dk.; Department of Surgery, Slagelse Hospital, Slagelse, Denmark. henry.george.smith@regionh.dk.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2023 Aug 29; Vol. 408 (1), pp. 341. Date of Electronic Publication: 2023 Aug 29.
DOI: 10.1007/s00423-023-03084-z
Abstrakt: Purpose: Small bowel obstruction (SBO) is a common surgical emergency. Previous studies have shown the value computed tomography (CT) scanning in both confirming this diagnosis and identifying indications for urgent surgical intervention, such as strangulated bowel or closed loop obstructions. However, most of the literature is based on retrospective expert review of previous imaging and little data regarding the real-time accuracy of CT reporting is available. Here, we investigated the real-world accuracy of CT reporting in patients admitted with SBO.
Methods: This was a multicentre prospective study including consecutive patients admitted with SBO. The primary outcomes were the sensitivity and specificity of CT scanning for bowel obstruction with ischaemia and closed loop obstruction. Data were retrieved from the original CT reports written by on-call radiologists and compared with operative findings.
Results: One hundred seventy-six patients were included, all of whom underwent CT scanning with intravenous contrast followed by operative management of SBO. Bowel obstruction with ischaemia was noted in 20 patients, with a sensitivity and specificity of CT scanning of 40.0% and 85.5%, respectively. Closed loop obstructions were noted in 26 patients, with a sensitivity and specificity of CT scanning of 23.1% and 98.0%, respectively.
Conclusions: The real-world accuracy of CT scanning appears to be lower than previously reported in the literature. Strategies to address this could include the development of standardised reporting schemas and to increase the surgeon's own familiarity with relevant CT features in patients admitted with SBO.
(© 2023. The Author(s).)
Databáze: MEDLINE
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