Benjamin M. Yeh MD, Abstract Co-Author: Nothing to Disclose

Parmbir Sandhu BS, Presenter: Nothing to Disclose

Fergus Vincent Coakley MD, Abstract Co-Author: Nothing to Disclose

Aliya Qayyum MD, Abstract Co-Author: Spouse, Employee, Koninklijke Philips Electronics NV (Stentor)

Antonio Carlos A. Westphalen MD, Abstract Co-Author: Nothing to Disclose

Bonnie N. Joe MD,PhD, Abstract Co-Author: Nothing to Disclose

To assess the relationship between the number and location of small bowel transition points seen at CT and the presence of small bowel volvulus in a surgical population.

We retrospectively identified 94 consecutive adult patients with surgically proven non-hernia small bowel obstruction who had preoperative abdominopelvic CT scans. The study group included 59 women and 35 men with a mean age of 57 years (range 18 to 91 years), of whom 34 had small bowel volvulus at laparotomy. One reader, blinded to the final diagnoses, recorded the number of bowel transition points at CT and the spine-to-transition point distance, which was defined as the mean distance between the anterior edge of the vertebral body to each of the transition points in the axial plane for each patient. We used Fishers exact test to assess the frequency of finding multiple transition points in patients with and without volvulus, and used unpaired t-tests to assess differences in average spine-to-transition point distances.

The frequency of finding multiple transition points was significantly higher in patients with volvulus (19 of 34 patients) than in patients without volvulus (9 of 60, p<0.005). The mean spine-to-transition point distance was significantly smaller for patients with small bowel volvulus (6.6 cm; range 2.8 to 12.8 cm) than for patients without volvulus (8.2 cm, range 2.0 to 15.0 cm, p < 0.05).

The CT findings of multiple transition points centrally located in the abdomen in patients with small bowel obstruction is associated with small bowel volvulus.

We report the first data on the central location and multiplicity of transition points at CT as predictors of small bowel volvulus.

Yeh, B, Sandhu, P, Coakley, F, Qayyum, A, Westphalen, A, Joe, B, Central Location and Multiplicity of Small Bowel Transition Points: Association with Volvulus in a Surgical Population.  Radiological Society of North America 2006 Scientific Assembly and Annual Meeting, November 26 - December 1, 2006 ,Chicago IL. http://archive.rsna.org/2006/4441798.html