Yoo Jin Lee MD, Presenter: Nothing to Disclose

Jong Yeol Kim MD, Abstract Co-Author: Nothing to Disclose

Gab Chul Kim, Abstract Co-Author: Nothing to Disclose

Hun Kyu Ryeom MD, Abstract Co-Author: Nothing to Disclose

Hui Joong Lee, Abstract Co-Author: Nothing to Disclose

Duk Sik Kang MD, Abstract Co-Author: Nothing to Disclose

To assess and compare the usefulness of clinical criteria, SIRS criteria, CT signs, US signs, and US-guided paracentesis with ascites analysis for diagnosis of strangulation in small bowel obstruction accompanied with ascites

Forty patients (19 male, 21female patients; mean age, 53 years; range, 15-87 years) underwent CT, US, and US-guided paracentesis for diagnosis of strangulation among 355 patients with small bowel obstruction clinically or surgically proven, from January 2005 to February 2008. All paracentesis were performed safely without any complication, using 23-gauge fine needle and aspirator device under US-guide. We examined each specimen to find whether color of ascites and laboratory parameters could be reliable indicators of strangulation. Medical record, CT, and US of all patients were reviewed for clinical criteria (tenderness, tachycardia, fever, and leukocytosis), SIRS criteria, CT signs, and US signs (no color flow in bowel wall and no peristalsis) used for diagnosis of strangulation in small bowel obstruction. χ2 test was used to assess associations between clinical criteria, SIRS criteria, CT signs, US signs, ascites analysis, and the diagnosis of strangulation.

28 patients underwent laparotomy and 12 patients treated conservatively. We confirmed strangulation obstruction in 17 patients and simple obstruction in 23 patients. 11 patients underwent bowel resection due to bowel infarction. There were significant associations of two CT signs (the decreased segmental enhancement and sign of closed loop obstruction) , two US signs (no color flow in bowel wall and no peristalsis), and sanguineous color of ascites with the presence of strangulation.

CT, US, and US-guided paracentesis with ascites analysis were useful methods for diagnosis of strangulation obstruction.

US-guided paracentesis could be useful for diagnosing strangulation in small bowel obstruction acompanied with ascites.

Lee, Y, Kim, J, Kim, G, Ryeom, H, Lee, H, Kang, D, Diagnosis of Strangulation in Small-Bowel Obstruction Accompanied with Ascites: Comparison with Clinical Criteria, Systemic Inflammatory Response Syndrome (SIRS) Criteria, CT Signs, Ultrasound (US) Signs, and US-guided Paracentesis.  Radiological Society of North America 2008 Scientific Assembly and Annual Meeting, February 18 - February 20, 2008 ,Chicago IL. http://archive.rsna.org/2008/6021271.html