Classic signs of closed loop bowel obstruction

Mandell, Jacob; Mullen, Katherine M.; Khurana, Bharti

doi:10.1007/s11739-012-0897-3

Cited by 4 publications

(1 citation statement)

References 5 publications

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“…Suggestive signs on CT images may be: dilated small bowel loops ≥ 2.5 cm up and normal calibre or collapsed loops distally or small bowel faecal sign (faecal like material in dilated small bowel loops). Closed-loop obstructions are diagnosed when a bowel loop is occluded at two adjacent points, showing radial distribution of several dilated, fluid-filled bowel loops, U-shaped or C-shaped configuration, beak sign at the site of fusiform tapering, whirl sign (rotation of bowel loops around a fixed point) [ 49 ]. Due to the possible lack of clinical information in the routine PET/CT practice, it is important to focus on the abnormal bowel aspect and then to communicate directly with patient and/or referring clinician for a better interpretation of the urgent condition (sub-occlusion versus occlusion) (category 2 vs. 1).…”

Section: Clinical Applicationsmentioning

confidence: 99%

Actionable imaging findings in the daily PET/CT scenario

Mattana

Zanoni

Nanni

et al. 2023

Clin Transl Imaging

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Background and aim The American College of Radiology (ACR) defines “actionable findings” the ones requiring a special communication between radiologists and referring clinicians, suggesting to organize their categorization in a three-degree scale on the basis of the risk for the patient to develop complications. These cases may fall in a grey-zone communication between different care figures with the risk of being underestimated or even not being considered at all. In this paper, our aim is to adapt the ACR categorization to the most frequent actionable findings encountered when reporting PET/CT images in a Nuclear Medicine Department, describing the most frequent and relevant imaging features and presenting the modalities of communication and the related clinical interventions that can be modulated by the prognostic severity of the clinical cases. Materials and methods We performed a descriptive, observational and critical analysis of the most relevant literature on the topic of “actionable findings”, in particular, starting from the reports of the ACR Actionable Reporting Work Group, we categorised and described, in a narrative review, the most relevant “actionable findings” encountered in the Nuclear Medicine PET/CT daily practice. Results To the best of our knowledge, to date there are no clear indications on this selective PET/CT topic, considering that the current recommendations target mainly radiologists and assume a certain level of radiological expertise. We resumed and classified the main imaging conditions under the term of “actionable findings” according to the corresponding anatomical districts, and we described their most relevant imaging features (independently of PET avidity or not). Furthermore, a different communication timing and strategy was suggested on the basis of the findings’ urgency. Conclusion A systematic categorization of the actionable imaging findings according to their prognostic severity may help the reporting physician to choose how and when to communicate with the referring clinician or to identify cases requiring a prompt clinical evaluation. Effective communication is a critical component of diagnostic imaging: timely receipt of the information is more important than the method of delivery.

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Section: Clinical Applicationsmentioning

confidence: 99%