Yasemin ALTINTAŞ, Mehmet BAYRAK, Omer ALABAZ

Bağırsak tıkanıklığının nadir nedenlerinin saptanmasında kontrastlı ve kontrastsız bilgisayarlı tomografinin değeri

Amaç: Bu çalışma, bağırsak tıkanıklıklarının nadir nedenlerini ortaya koymayı ve kontrastlı veya kontrastsız bilgisayarlı tomografinin tanısal doğruluğunu karşılaştırmayı amaçlamaktadır.Gereç ve Yöntem: 15 Ocak 2009 ve 15 Haziran 2018 tarihleri arasında, acil serviste veya hastanede akut mekanik bağırsak tıkanıklığı tanısı alan hastalar retrospektif olarak değerlendirildi. Veriler hasta dosyalarından ve görüntüleme sisteminden elde edildi. Mekanik bağırsak tıkanıklığı tanısı; muayene, klinik bulgular ve bilgisayarlı tomografi tetkikine dayanarak koyuldu. Bulgular: Hastaların 46'sı kadın ve 41'i erkek ve yaş aralığı 20 ila 81 arasında idi. Mekanik tıkanıklığı olan hastalarda 58 (% 66.7) ince bağırsaktan ve 29 (% 33.3) kalın bağırsaktan kaynaklanmakta idi. Yaş, beden kitle indeksi ve kontrast kullanımı ile nadir görülen ince ve kalın barsak nedenleri karşılaştırıldığında, aralarında anlamlı bir fark saptanmadı. Altın standart cerrahi ile karşılaştırıldığında, kontrastlı veya kontrastsız bilgisayarlı tomografi bulgularının duyarlılık, özgüllük, pozitif prediktif değer, negatif prediktif değer ve tanısal doğruluğu sırası ile % 93,9, % 93.3, % 96.9, % 87.5, % 94 ve % 96.0, % 85.7, % 92.3, % 92.3, % 92.3 idi.Sonuç: Kontrastsız bilgisayarlı tomografi, bağırsak tıkanıklığının yerini, şiddetini ve etiyolojisini tanımlamak için kontrastlı bilgisayarlı tomografi ile karşılaştırıldığında benzer bir tanısal doğruluk, duyarlılık ve özgüllüğe sahip olduğu saptanmıştır.

Value of enhanced or non-enhanced computed tomography in the detection of rare causes of bowel obstruction

Purpose: This study aims to reveal the uncommon causes of intestinal obstructions and to compare the diagnostic accuracy of enhanced or non-enhanced computed tomography.Materials and Methods: This cohort was a retrospective study of different patients diagnosed with acute mechanical intestinal obstruction in the emergency room or hospital between 15 January 2009 and 15 June 2018. Exclusion criteria were common causes of mechanical bowel obstruction and inclusion criteria were uncommon causes of bowel obstruction. Non-enhanced or enhanced computed tomography were used to diagnose mechanical bowel obstruction.Results: The population included 46 females and 41 males and the age range from 20 to 81. Of the patients with uncommon mechanical obstruction, 58 (66.7 %) were caused by the small intestine, and 29 (33.3%) by the large intestine. When compared to uncommon causes of the small and large bowel with age, body mass index, and use of contrast or not, no significant difference was detected between them. Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of enhanced computed tomography were %93.9, %93.3, %96.9, %87.5, %94 and non-enhanced computed tomography were %96.0, %85.7, %92.3, %92.3, %92.3 respectively.Conclusion: Non-enhanced computed tomography has similar diagnostic accuracy, sensitivity, and specificity compared to enhanced computed tomography for identifying the location, severity, and etiology of bowel obstruction.

Keywords:

computed tomography, bowel obstruction, non enhanced CT,

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