Comparison of Computed Tomography Findings and Intraoperative Correlation in Adult Patients Presenting with Symptoms of Intestinal Obstruction

Abstract

Background: Intestinal obstruction is a common surgical emergency, accounting for approximately 15% of all emergency department visits for abdominal pain and around 20% of the total volume of emergency surgical procedures. Multi-detector computed tomography (Multi-Detector Computed Tomography, MDCT) is the preferred first-line assessment method for this condition. The present study adopts intraoperative outcomes as the gold standard to evaluate the diagnostic accuracy of this modality for intestinal obstruction. Objective: To evaluate the diagnostic accuracy of MDCT in intestinal obstruction, using intraoperative findings as the reference standard. Methodology: This is an observational study of patients undergoing intestinal obstruction surgery, conducted at FAAMCH in Bapeeta, Assam. The 12-month study enrolled 40 confirmed patients aged 18 to 70 years. All participants received plain and contrast-enhanced MDCT scans performed with a Philips MX16-slice scanner, and imaging results were compared with findings from intraoperative exploration. Results: The most common age group affected was 46–60 years (40%), with a male predominance (62.5%). Small bowel obstruction was present in 77.5% of cases. The leading etiology was adhesion/bands (30%), followed by hernia (17.5%) and neoplasm (15%). MDCT correlated with intraoperative findings in 36 of 40 patients (90%). Sensitivity was 94.7%, specificity 100%, PPV 100%, NPV 50%, and accuracy 95%. Conclusion: MDCT demonstrates high diagnostic accuracy for intestinal obstruction and serves as an indispensable preoperative tool guiding surgical decision-making. Its ability to identify the site, cause, and complications of obstruction positions it as the imaging modality of choice in emergency abdominal settings.