Multi-slice CT Evaluation of Significance of Small Bowel Feces Sign in Small-bowel Obstruction

Objective:To explore the value of small bowel feces sign(SBFS) in CT examination of patients with small bowel obstruction. Materials:76 consecutive patients with Small-bowel obstruction were prospectively evaluated from February 2017 to February 2019. They were performed by 256-slice CT enhanced scans, and then analyzed the patient's axial, coronal and sagittal imaging data. All patients were divided into mild, moderate, or high-grade groups according to the degree of obstruction. All patients were divided into adhesion, inflammation, tumor, Crohn's disease, and hernia groups according to the cause of the SBO. According to the presence or absence of the SBFS, the cases were differentiated positive and negative respectively. Each group of positive cases were depicted detailed in the location, size, relation to the transition zone of the SBFS. The cause of the obstruction was decided from surgical results or follow-up CT findings. Evaluate differences in SBFS in different groups by statistical analysis. Result:The SBFS was presented in 42 of 76 patients. 13 cases were the mild small intestinal obstruction, 25 cases were the moderate, and 38 cases were the high-grade. The SBFS presenting in mild, moderate, and high-grade SBO was 2, 16 and 24 respectively. The SBFS presenting in adhesion, inflammation, tumor, Crohn's disease, and hernia groups was 22, 10, 5, 5 and 4 respectively. Among the positive cases in each group, 35(83.3%) patients with SBFS were able to clearly locate the obstructed transition zone, with a long axis range of about 4.5~22.1 cm and a CT range of about-215 to 9 HU. Significant differences were found regarding the probability of SBFS presenting in the moderate and high-grade group than that in mild group(P<0.05). No significant differences were found regarding the probability of SBFS presenting in adhesion, inflammation, tumor, Crohn's disease, hernia groups(P>0.05). Conclusion:The presence of SBFS can locate transition zone in SBO patients fast and accurately, and to help clinical diagnosis and treatment.