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ORIGINAL ARTICLE
Year : 2017  |  Volume : 5  |  Issue : 2  |  Page : 65-70

Role of computed tomography scoring system in management of small-bowel obstruction


1 Department of Surgery, ESI PGIMSR, New Delhi, India
2 Department of Microbiology, ESI PGIMSR, New Delhi, India
3 Department of Surgery, Subharti Medical College, Meerut, Uttar Pradesh, India

Correspondence Address:
Atul Jain
Department of Surgery, ESI PGIMSR, Basaidarapur, New Delhi
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ssj.ssj_6_17

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Context: Patients with a bowel obstruction still represent some of the most difficult and vexing problems that surgeons face with regard to the correct diagnosis, optimal timing of therapy, and appropriate treatment. Aims: The aim of this study was to study the role of computed tomography (CT) in determining the etiology and intervention in intestinal obstruction with specific role of CT scoring system in decision-making. Settings and Design: This prospective study was conducted in the Department of General Surgery of a medical college of North India, for 2 years. Materials and Methods: In this study, we have selected patients with all age group who attended to outpatient department and emergency department at CSSH hospital with history and clinical picture suggestive of intestinal obstruction. Statistical Analysis Used: Positive predictive value, negative predictive value, and accuracy. Results: In our study, CT scoring system helped 81% of time in predicting the requirement of surgery. CT scoring has less sensitivity toward the cases with congenital malformation and those cases should be managed on basis of clinical and other parameters as conservative management in such cases have high rate of recurrence of obstruction and other complications. Conclusions: Clinical sense remains the mainstay of deciding the line of management in cases of intestinal obstruction. CT in these patients can help surgeon to go for surgery early and prevent complications. It also helps in preventing unnecessary surgeries in patient who can be managed conservatively. CT scoring system is less sensitive for congenital malformations and other CT features along with clinical features are mainstay for decision-making in these patients.


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