Advertisement

Small Bowel Obstruction: When Is X-Ray Enough?

  • Lauren M. Westafer
Chapter

Abstract

Abdominal x-rays are frequently ordered in patients with suspected small bowel obstruction (SBO). However, this practice is discouraged by the American College of Radiology due to poor sensitivity. Abdominal x-rays have insufficient sensitivity (75%) and specificity (66%) to rule in or rule out a diagnosis of SBO. Further, x-rays lack reliable information on the etiology and level of obstruction, almost always warranting further imaging. In most cases, alternative diagnostic modalities such as ultrasound and computed tomography should be used to diagnose SBO.

Keywords

Small bowel obstruction Emergency radiology Abdominal radiographs 

References

  1. 1.
    Ros PR, Huprich JE. ACR appropriateness criteria on suspected small-bowel obstruction. J Am Coll Radiol. 2006;3(11):838–41.CrossRefGoogle Scholar
  2. 2.
    Fukuya T, Hawes DR, Lu CC, Chang PJ, Barloon TJ. CT diagnosis of small-bowel obstruction: efficacy in 60 patients. AJR Am J Roentgenol. 1992;158(4):765–9; discussion 771–2.CrossRefGoogle Scholar
  3. 3.
    Maglinte DD, Reyes BL, Harmon BH. Reliability and role of plain film radiography and CT in the diagnosis of small-bowel obstruction. AJR Am J Roentgenol. 1996;167(6):1451–5.CrossRefGoogle Scholar
  4. 4.
    Taylor MR, Lalani N. Adult small bowel obstruction. Acad Emerg Med. 2013;20(6):528–44.CrossRefGoogle Scholar
  5. 5.
    Frager DH, Baer JW, Rothpearl A, Bossart PA. Distinction between postoperative ileus and mechanical small-bowel obstruction: value of CT compared with clinical and other radiographic findings. AJR Am J Roentgenol. 1995;164(4):891–4.CrossRefGoogle Scholar
  6. 6.
    Suri S, Gupta S, Sudhakar PJ, Venkataramu NK, Sood B, Wig JD. Comparative evaluation of plain films, ultrasound and CT in the diagnosis of intestinal obstruction. Acta Radiol. 1999;40(4):422–8.CrossRefGoogle Scholar
  7. 7.
    Musoke F, Kawooya MG, Kiguli-Malwadde E. Comparison between sonographic and plain radiography in the diagnosis of small bowel obstruction at Mulago Hospital, Uganda. East Afr Med J. 2003;80(10):540–5.PubMedGoogle Scholar
  8. 8.
    Gottlieb M, Peksa GD, Pandurangadu AV, Nakitende D, Takhar S, Seethala RR. Utilization of ultrasound for the evaluation of small bowel obstruction: a systematic review and meta-analysis. Am J Emerg Med. 2018;36(2):234–42.CrossRefGoogle Scholar
  9. 9.
    Jang TB, Schindler D, Kaji AH. Bedside ultrasonography for the detection of small bowel obstruction in the emergency department. Emerg Med J. 2011;28(8):676–8.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Lauren M. Westafer
    • 1
  1. 1.Department of Emergency Medicine, Baystate Medical Center/UMMSSpringfieldUSA

Personalised recommendations