A Comparative Study Between Clinical Diagnosis and Operative Findings of Small Bowel Obstruction

Abstract

Objectives: To compare the diagnostic accuracy of different methods of clinical diagnosis (plain x-rays, ultrasonography and CT scan) for small bowel obstruction keeping operative finding as gold standard.

Study design: Validation study.

Place and Duration of the study: Combined Military Hospital, Lahore from July-2024 to December-2024.

Methodology: A total of 126 patients presenting with clinical features suggestive of bowel obstruction were included. All these patients underwent careful clinical evaluation through plain abdominal x-rays, abdominal ultrasound and CT abdomen to make clinical diagnosis of small bowel obstruction by each modality. These findings were compared with the operative findings. Based on this 2x2 contingency table was made to calculate diagnostic accuracy parameters.

Results: In this study, 126 patients were included with a median age of 57.00 (80.00 – 18.00) years. There were 76 (60.32%) male and 50 (39.68%) female patients. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of abdominal x-rays were 60.00%, 71.43%, 91.30%, 26.32% and 61.90%; of abdominal ultrasound were 79.05%, 76.19%, 94.32%, 42.11% and 78.57%; and of abdominal CT were 90.48%, 90.48%, 97.94%, 65.52% and 90.48%, respectively.

Conclusion: Ultrasound and CT abdomen are highly useful tools in making clinical diagnosis of small bowel obstruction prior to surgery.