Acute non traumatic abdominal pain of small bowel origin: Can multi-detector CT enterography provide a potential contribution to the diagnosis of underlying causes?

Abstract

Purpose: To analyze the diagnostic value of multi-detector CT enterography (MDCTE) in identifying small bowel causes of acute non traumatic abdominal pain and in determining the extent of bowel lesion. Patients and methods: A total of 73 patients (42 males and 31 females aged from 12 to 85 years) who presented with acute non traumatic abdominal pain and were evaluated with computed tomography enterography (MDCTE) between August 2014 and July 2017 were enrolled in the study. The diagnostic value of MDCTE was analyzed by using the results of other imaging modalities, endoscopy, surgery, pathology and clinical follow-up as the reference standards. Results: MDCTE correctly made the diagnosis in 66 of 73 patients (true positive), 7 cases were missed by CTE findings (false negative cases) and one case of ileus was falsely diagnosed as small bowel obstruction with an overall sensitivity of 90%, specificity = 93%, PPV = 98%, NPV = 71%. The diagnostic accuracy of each CT sign was calculated independently for each underlying etiology. Conclusion: The use of MDCTE may be of significant value in identifying the cause of acute abdominal pain of small bowel etiology, in determining disease activity in inflammatory causes and identifying the level and cause of obstruction in SBO. Keywords: Acute abdomen, Multidetector CT enterography