Correlation of Multidetector CT Findings with Intraoperative Findings in Intestinal Obstruction

Abstract

Introduction: Intestinal obstruction is a common surgical emergency with significant morbidity. Accurate preoperative identification of its level and cause is essential, and multidetector computed tomography (MDCT) plays a key role in timely evaluation. This study aims to assess the accuracy of MDCT in identifying the level and cause of obstruction by comparing imaging findings with intraoperative results.
Methods: This cross-sectional study was conducted in the Department of Radiodiagnosis and Imaging at Pokhara Manipal College of Medical Sciences between October 2024 and December 2025. Fifty adult patients with clinically diagnosed intestinal obstruction who underwent contrast enhanced MDCT and surgery were included. CT findings on the level and cause of obstruction were compared with intraoperative findings using Fisher’s exact test.
Results: Mean age of patients was 61.46 years, with a male predominance. Malignancy was the most common cause of intestinal obstruction, accounting for 34% of cases on both CT and ] intraoperative evaluation, followed by bands and adhesions. The ileum, particularly the terminal and mid ileum, was the most often involved segment. A strong and statistically significant correlation was found between MDCT findings and intraoperative diagnoses for both the level and cause of obstruction (p < 0.01). Small discrepancies were noted, mainly involving differentiation between adhesive bands and internal hernias.

Conclusions: MDCT accurately identifies the level and cause of intestinal obstruction, correlates well with operative findings, and supports early diagnosis and surgical planning.