CT scan findings do not predict outcome of nonoperative management in small bowel obstruction: Retrospective analysis of 108 consecutive patients.

Objectives: The study purpose was to investigate the ability of Emergency Department CT scan to predict the need for operative intervention in patients hospitalized for small bowel obstruction (SBO) likely secondary to adhesions (ASBO) and initially managed nonoperatively.

Design: Retrospective case series. Statistical analysis was done with independent-samples t-test and chi-square to identify correlation between variables and outcome of nonoperative management.

Setting: Tertiary care academic medical center.

Patients And Methods: Of 200 consecutive patients hospitalized for SBO, 108 were included in the study with a diagnosis of ASBO and received initial nonoperative management. Exclusion criteria were need for emergency surgery (e.g. peritonitis) or other diagnoses (e.g. neoplasms, hernias, Crohn's disease). CT findings such as transition point, small bowel faeces, high grade obstruction, and abnormal vascular course were correlated with failure of nonoperative management.

Results: Only 18 patients (16.7%) required operative intervention, while the other 90 (83.3%) were successfully discharged after nonoperative care. There was no correlation between CT scan findings and treatment outcome.

Conclusions: Emergency Department CT scan findings do not significantly alter management decisions in patients admitted for ASBO and managed initially with nonoperative care.