Ileus CT

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Akshun Kalia M.B.B.S.[2]

Overview

An abdominal and pelvic CT scan is used to confirm the diagnosis of postoperative ileus only in cases when an x-ray is not diagnostic. An abdomen and pelvis CT scan (with intravenous contrast and oral water soluble contrast) can also distinguish early postoperative ileus from mechanical obstruction. In addition, a CT scan can also identify other complications seen in the post-operative period or ileus related complications, such as perforation, strangulation and necrosis. Findings on a CT scan diagnostic of postoperative ileus include multiple air–fluid levels throughout the abdomen, elevated diaphragm, and dilation of both large and small intestine with no evidence of mechanical obstruction.

CT

An abdominal and pelvic CT scan is used to confirm the diagnosis of postoperative ileus only in cases when an x-ray is not diagnostic. An abdomen and pelvis CT scan (with intravenous contrast and oral water soluble contrast) can also distinguish early postoperative ileus from mechanical obstruction. In addition, aCT scan can also identify other complications seen in the postoperative period or ileus related complications, such as perforation, strangulation and necrosis. Findings on a CT scan diagnostic of postoperative ileus include:[1][2][3]

Abdomen and pelvic CT scan showing ileus.(Source: Case courtesy of Dr David Cuete, <a href="https://radiopaedia.org/">Radiopaedia.org</a>. From the case <a href="https://radiopaedia.org/cases/33988">rID: 33988</a>)

References

  1. Frager DH, Baer JW, Rothpearl A, Bossart PA (1995). "Distinction between postoperative ileus and mechanical small-bowel obstruction: value of CT compared with clinical and other radiographic findings". AJR Am J Roentgenol. 164 (4): 891–4. doi:10.2214/ajr.164.4.7726042. PMID 7726042.
  2. Tollesson PO, Cassuto J, Rimbäck G (1992). "Patterns of propulsive motility in the human colon after abdominal operations". Eur J Surg. 158 (4): 233–6. PMID 1352138.
  3. Hansmann J, Eichholz J (2012). "[Radiological diagnostics of the small bowel]". Radiologe (in German). 52 (9): 849–66. doi:10.1007/s00117-011-2278-8. PMID 22940683.

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