Role of Computed Tomography in Evaluation of Different Causes of Intestinal Obstruction Correlated With Operative Findings

Intestinal Obstruction Clinical Trial

Official title:

Role of Computed Tomography in Evaluation of Different Causes of Intestinal Obstruction Correlated With Operative Findings

Clinical Trial Details — Status: Not yet recruiting

Administrative data

• NCT number: NCT05117645
• Other study ID #: soh-med-21-11-04
• Status: Not yet recruiting
• Start date: December 2021
• Est. completion date: June 2022

Study information

• Verified date: November 2021
• Source: Sohag University
• Contact: Alaa N Abd El ghafar, resident
• Phone: 01063550892
• Email: alaa011053[@]med.sohag.edu.eg
• Is FDA regulated: No
• Study type: Observational

Clinical Trial Summary

Intestinal obstruction is a common clinical problem that occurs secondary to mechanical or functional obstruction of the intestine, preventing normal transit of its contents. It is a frequent cause of hospitalization and represents 15-20% of surgical admissions for acute abdominal pain .

The underlying aetiology of large bowel obstructions (LBOs) is age dependent, but in adulthood, the most common cause is colonic cancer (50-60%), typically in the sigmoid. The second most common cause in adults is acute diverticulitis (involving the sigmoid colon). Together, obstructing tumors and acute diverticulitis account for 90% of all causes of LBO.

Adhesions are the most common cause of small bowel obstruction (SBO) , For practical purposes, they do not tend to cause LBO.Other causes which cause symptoms that are mimic intestinal obstruction as in bowel ischemia that mainly caused by mesenteric vessels occlusion (adynamic obstruction).

Computed tomography (CT) has become a mainstay in diagnosing bowel obstruction. This is because the management of obstruction has dramatically changed with a decrease in the proportion of patients who need surgery Multi Detector Computed Tomography scanners provide a huge gain in performance that can be used to reduce the scan time, reduce section collimation, or to increase scan length surgery.

Diagnosis of intestinal obstruction is established by patient history and clinical findings include abdominal distension, acute abdominal pain, vomiting and inability to pass stools or flatus .

The role of CT in diagnosing intestinal obstruction has been expanding by determining presence, degree, level and cause (extrinsic lesions, intrinsic lesions, intussusception, intraluminal lesions) of obstruction and in identifying any associated strangulation, and also it has an important role in diagnosing the mesenteric vessels obstruction by thrombi by injection of IV contrast media which causes adynamic bowel obstruction .

Recruitment information / eligibility

• Status: Not yet recruiting
• Enrollment: 50
• Est. completion date: June 2022
• Est. primary completion date: June 2022
• Gender: Female
• Age group: 1 Year and older

Eligibility

Inclusion Criteria:

• Any age group and gender presented by manifestations of acute intestinal obstruction.

Exclusion Criteria:

• Pregnant women.

Related Conditions & MeSH terms

• Intestinal Obstruction

Intervention

Diagnostic Test:
• Computed tomography
All patients will be examined by multislice CT scanner,Light speed 5X GE 8 detector elements scanner or GE Revolution Evo 128 multidetector elements scanner (GE Healthcare, Chicago, Illinois, United state) or Toshibe Alexion 16 detector elements scanner (Aplio 500, Toshiba Medical Systems, Otawara-shi, Tochigi 324-8550, Japan). Axial scanns will be done commences at 1 cm above the diaphragm and ending at lesser trochanters then coronal and sagittal reconstruction images will be exposed.

Locations

Country	Name	City	State
Egypt	Sohag University Hospital	Sohag

Sponsors (1)

Lead Sponsor	Collaborator
Sohag University

Country where clinical trial is conducted

Egypt, 

References & Publications (3)

De Monti M, Cestaro G, Alkayyali S, Galafassi J, Fasolini F. Gallstone ileus: A possible cause of bowel obstruction in the elderly population. Int J Surg Case Rep. 2018;43:18-20. doi: 10.1016/j.ijscr.2018.01.010. Epub 2018 Feb 4. — View Citation

Jaffe T, Thompson WM. Large-Bowel Obstruction in the Adult: Classic Radiographic and CT Findings, Etiology, and Mimics. Radiology. 2015 Jun;275(3):651-63. doi: 10.1148/radiol.2015140916. Review. — View Citation

van Steensel S, van den Hil LCL, Schreinemacher MHF, Ten Broek RPG, van Goor H, Bouvy ND. Adhesion awareness in 2016: An update of the national survey of surgeons. PLoS One. 2018 Aug 17;13(8):e0202418. doi: 10.1371/journal.pone.0202418. eCollection 2018. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Emphasization the role of the MDCT in the evaluation of intestinal obstruction.	Patients complaining of intestinal obstruction will undergo oral preparation according to their condition then will undergo CT abdomen and pelvis , some of them will undergo exploration others will be observed then comparison with operative findings and observation will be done.	6 months