Multidetector Row Computed Tomography of Small Bowel Obstruction

Small bowel obstruction (SBO) is a common clinical problem, and clinical signs and symptoms often do not provide sufficient information for diagnosis or to guide management. During the past two decades, computed tomography has become a mainstay in the evaluation of patients with known or suspected small bowel obstruction. Computed tomography scans should be performed and interpreted with attention to establishing the diagnosis of small bowel obstruction, locating the transition point indicating the site of obstruction, and determining the cause of the obstruction. Complications that suggest the need for urgent surgical intervention, such as closed loop obstruction with superimposed ischemia and/or volvulus, should be sought in every case. Current generation multidetector row computed tomography scanners, with their isotropic resolution, now permit high-quality reformatted images to be obtained in multiple planes and facilitate identification of the transition point and other findings in SBO. Radiologists should be familiar with the myriad features of uncomplicated and complicated small bowel obstruction, which are reviewed in this article.