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Small Bowel Obstruction
Atif Zaheer, MD; Gabriela Gayer, MD; Michael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Small bowel obstruction (SBO)
            • Definitions

              • Obstruction or blockage of ≥ 1 SB segments by intrinsic or extrinsic narrowing of SB lumen

            IMAGING

            • General Features

              • Radiographic Findings

                • Fluoroscopic Findings

                  • CT Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Staging, Grading, & Classification

                            • Gross Pathologic & Surgical Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Bouassida M et al: Predicting intestinal ischaemia in patients with adhesive small bowel obstruction: a simple score. World J Surg. 44(5):1444-9, 2020
                                          2. Calame P et al: Transmural bowel necrosis from acute mesenteric ischemia and strangulated small-bowel obstruction: distinctive CT features. AJR Am J Roentgenol. 214(1):90-5, 2020
                                          3. Morosin T et al: Gallstone ileus: an unusual cause of intestinal obstruction. Cureus. 12(3):e7284, 2020
                                          4. Murata M et al: 3D vessel image reconstruction by MDCT for surgical indication and timing of strangulating small bowel obstructions. World J Surg. 44(4):1105-12, 2020
                                          5. Zhou J et al: Diagnostic significance of multidetector computed tomography (MDCT) in patients with small bowel obstruction: a meta-analysis. Jpn J Radiol. 38(5):458-62, 2020
                                          6. Diamond M et al: Small bowel obstruction and ischemia. Radiol Clin North Am. 57(4):689-703, 2019
                                          7. Li Z et al: Diagnostic utility of CT for small bowel obstruction: Systematic review and meta-analysis. PLoS One. 14(12):e0226740, 2019
                                          8. Renko AE et al: Peritoneal encapsulation: a rare cause of small bowel obstruction. BMJ Case Rep. 12(4), 2019
                                          9. Tamburrini S et al: Diagnostic accuracy of ultrasound in the diagnosis of small bowel obstruction. Diagnostics (Basel). 9(3), 2019
                                          10. D'Agostino R et al: Small bowel obstruction and the gastrografin challenge. Abdom Radiol (NY). 43(11):2945-54, 2018
                                          11. Kagoma YK et al: Computed tomography of internal hernias following laparoscopic Roux-en-Y gastric bypass surgery. Semin Ultrasound CT MR. 39(2):145-50, 2018
                                          12. Khaled W et al: Clinical relevance of the feces sign in small-bowel obstruction due to adhesions depends on its location. AJR Am J Roentgenol. 210(1):78-84, 2018
                                          13. Mu JF et al: Clinical factors associated with intestinal strangulating obstruction and recurrence in adhesive small bowel obstruction: a retrospective study of 288 cases. Medicine (Baltimore). 97(34):e12011, 2018
                                          14. Rondenet C et al: Increased unenhanced bowel-wall attenuation: a specific sign of bowel necrosis in closed-loop small-bowel obstruction. Eur Radiol. 28(10):4225-33, 2018
                                          15. Scrima A et al: Value of MDCT and clinical and laboratory data for predicting the need for surgical intervention in suspected small-bowel obstruction. AJR Am J Roentgenol. 208(4):785-93, 2017
                                          16. Burgess LK et al: The string of pearls sign. Abdom Radiol (NY). 41(7):1435-6, 2016
                                          17. Doishita S et al: Internal hernias in the era of multidetector CT: correlation of imaging and surgical findings. Radiographics. 36(1):88-106, 2016
                                          18. Baheti AD et al: MDCT and clinicopathological features of small bowel gastrointestinal stromal tumours in 102 patients: a single institute experience. Br J Radiol. 88(1053):20150085, 2015
                                          19. Lee KH et al: Ultrasonographic differentiation of bezoar from feces in small bowel obstruction. Ultrasonography. 34(3):211-6, 2015
                                          20. Millet I et al: Value of CT findings to predict surgical ischemia in small bowel obstruction: a systematic review and meta-analysis. Eur Radiol. 25(6):1823-35, 2015
                                          21. O'Malley RG et al: MDCT findings in small bowel obstruction: implications of the cause and presence of complications on treatment decisions. Abdom Imaging. 40(7):2248-62, 2015
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Clinical Issues

                                                  • Diagnostic Checklist

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Small bowel obstruction (SBO)
                                                    • Definitions

                                                      • Obstruction or blockage of ≥ 1 SB segments by intrinsic or extrinsic narrowing of SB lumen

                                                    IMAGING

                                                    • General Features

                                                      • Radiographic Findings

                                                        • Fluoroscopic Findings

                                                          • CT Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Staging, Grading, & Classification

                                                                    • Gross Pathologic & Surgical Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Bouassida M et al: Predicting intestinal ischaemia in patients with adhesive small bowel obstruction: a simple score. World J Surg. 44(5):1444-9, 2020
                                                                                  2. Calame P et al: Transmural bowel necrosis from acute mesenteric ischemia and strangulated small-bowel obstruction: distinctive CT features. AJR Am J Roentgenol. 214(1):90-5, 2020
                                                                                  3. Morosin T et al: Gallstone ileus: an unusual cause of intestinal obstruction. Cureus. 12(3):e7284, 2020
                                                                                  4. Murata M et al: 3D vessel image reconstruction by MDCT for surgical indication and timing of strangulating small bowel obstructions. World J Surg. 44(4):1105-12, 2020
                                                                                  5. Zhou J et al: Diagnostic significance of multidetector computed tomography (MDCT) in patients with small bowel obstruction: a meta-analysis. Jpn J Radiol. 38(5):458-62, 2020
                                                                                  6. Diamond M et al: Small bowel obstruction and ischemia. Radiol Clin North Am. 57(4):689-703, 2019
                                                                                  7. Li Z et al: Diagnostic utility of CT for small bowel obstruction: Systematic review and meta-analysis. PLoS One. 14(12):e0226740, 2019
                                                                                  8. Renko AE et al: Peritoneal encapsulation: a rare cause of small bowel obstruction. BMJ Case Rep. 12(4), 2019
                                                                                  9. Tamburrini S et al: Diagnostic accuracy of ultrasound in the diagnosis of small bowel obstruction. Diagnostics (Basel). 9(3), 2019
                                                                                  10. D'Agostino R et al: Small bowel obstruction and the gastrografin challenge. Abdom Radiol (NY). 43(11):2945-54, 2018
                                                                                  11. Kagoma YK et al: Computed tomography of internal hernias following laparoscopic Roux-en-Y gastric bypass surgery. Semin Ultrasound CT MR. 39(2):145-50, 2018
                                                                                  12. Khaled W et al: Clinical relevance of the feces sign in small-bowel obstruction due to adhesions depends on its location. AJR Am J Roentgenol. 210(1):78-84, 2018
                                                                                  13. Mu JF et al: Clinical factors associated with intestinal strangulating obstruction and recurrence in adhesive small bowel obstruction: a retrospective study of 288 cases. Medicine (Baltimore). 97(34):e12011, 2018
                                                                                  14. Rondenet C et al: Increased unenhanced bowel-wall attenuation: a specific sign of bowel necrosis in closed-loop small-bowel obstruction. Eur Radiol. 28(10):4225-33, 2018
                                                                                  15. Scrima A et al: Value of MDCT and clinical and laboratory data for predicting the need for surgical intervention in suspected small-bowel obstruction. AJR Am J Roentgenol. 208(4):785-93, 2017
                                                                                  16. Burgess LK et al: The string of pearls sign. Abdom Radiol (NY). 41(7):1435-6, 2016
                                                                                  17. Doishita S et al: Internal hernias in the era of multidetector CT: correlation of imaging and surgical findings. Radiographics. 36(1):88-106, 2016
                                                                                  18. Baheti AD et al: MDCT and clinicopathological features of small bowel gastrointestinal stromal tumours in 102 patients: a single institute experience. Br J Radiol. 88(1053):20150085, 2015
                                                                                  19. Lee KH et al: Ultrasonographic differentiation of bezoar from feces in small bowel obstruction. Ultrasonography. 34(3):211-6, 2015
                                                                                  20. Millet I et al: Value of CT findings to predict surgical ischemia in small bowel obstruction: a systematic review and meta-analysis. Eur Radiol. 25(6):1823-35, 2015
                                                                                  21. O'Malley RG et al: MDCT findings in small bowel obstruction: implications of the cause and presence of complications on treatment decisions. Abdom Imaging. 40(7):2248-62, 2015