Positive predictive value of CT scan in detecting bowel ischemia in adhesive small bowel obstruction taking operative findings as gold standard

Aim: to determine positive predictive value of computed tomography scan in detecting bowel ischemia in adhesive small bowel obstruction taking operative findings as gold standard. methods: this cross sectional study was comprised 170 cases and conducted at department of surgery jinnah hospital lahore over a period 6 months from 21-07-2015 to 20-12-2015. all patients with diagnosis of adhesive small bowel obstruction were included. after taking the informed consent patients were advised computed tomography scan with iv and oral water soluble contrast along with baseline investigations findings of bowel ischemia were noted and reported by consultant radiologist. instead of routine conservative management,early surgical intervention by laparotomy was carried out on the basis of computed tomography scan finding of ischemia by 4th year postgraduate resident under consultant's supervision. operative finding of bowel ischemia during laparotomy was noted. results: mean age of patients was 38.75±11.44 years. positive predictive value of computed tomography in detecting bowel ischemia in adhesive small bowel obstruction was 91.2% and on computed tomography scan,bowel ischemia was seen in 155 patients. conclusion: computed tomography can efficiently diagnose the cases of bowel ischemia in adhesive small bowel obstruction.