Prospective Evaluation of Ultrasound in Distal Ileal and Colonic Obstruction

Grunshaw, N.D.; Renwick, Ian; Scarisbrick, G.; Nasmyth, D. G.

doi:10.1053/crad.2000.0434

Cited by 28 publications

(18 citation statements)

References 24 publications

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“…A paralytic ileus is assumed to be the cause of small bowel dilatation when there is an absence of peristalsis [31,40]. Two more recent studies used measurements of > 2.0±2.5 cm in the jejunum and > 1.5±2.0 cm in the ileum together with a zone of transition beyond which dilated bowel could not be identified [41,42]. Adynamic ileus is diagnosed when there is abundant gas in small bowel loops and colonic distension with intraluminal gas, fluid or stool together with absent peristaltic motion.…”

Section: Ultrasoundmentioning

confidence: 99%

Small bowel obstruction: the role of computed tomography in its diagnosis and management with reference to other imaging modalities

2001

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Small bowel obstruction is a leading cause of acute surgical admissions for abdominal pain. There is an increasing tendency for initial conservative management rather than immediate operative intervention, as a proportion of cases will resolve spontaneously. This has resulted in a growing reliance on radiological investigations to reassure the surgeon that medical therapy can be safely instituted. The onus therefore rests with radiologists to guide their surgical colleagues by correctly interpreting the plain abdominal radiograph and suggesting appropriate further investigation if warranted. Recently, computed tomography (CT) has been proposed as the test of choice to define the level and cause of acute small bowel obstruction and to identify complications such as ischaemia and perforation which will prompt surgical intervention. This review will discuss the utility of early CT in the diagnosis of acute small bowel obstruction and outline its impact on patient management.

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Section: Ultrasoundmentioning

confidence: 99%

Small bowel obstruction: the role of computed tomography in its diagnosis and management with reference to other imaging modalities

2001

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“…Tanto la sensibilidad como la especificidad alcanzadas, en ambos casos, son similares a las publicadas en la literatura, si bien es cierto que, especialmente en el caso del cáncer gástrico, el número de pacientes con este diagnóstico es muy reducido. En lo que al diagnóstico del cáncer de colon se refiere, nuestras cifras (sensibilidad del 100%, una especificidad del 94,5%) están bastante por encima de las obtenidas por otros autores que también han usado la ecografía convencional (14)(15)(16)(17)(18)(19)(20) y están muy próximas a las obtenidas mediante ecografía hidrocolónica (21)(22)(23)(24)(25)(26). Ya en un estudio previo publicado recientemente por nuestro grupo (aunque en este caso se incluían pacientes en los que se sospechaba específicamente un cáncer de colon e incluíamos a 42 pacientes con cáncer de colon) se obtenían unas cifras de precisión diagnóstica similares (27).…”

Section: Discussionunclassified

Utilidad de la ecografía en el diagnóstico de los pacientes con sospecha de neoplasias del tubo digestivo

Ares

Aguirre

Barrenechea

et al. 2008

Rev. esp. enferm. dig.

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RESUMENIntroducción: el valor predictivo positivo de síntomas y signos en el diagnóstico del cáncer de colon y gástrico es bajo. Además, muchos pacientes son remitidos para descartar una neoplasia digestiva, sin síntomas que sugieran su localización, siendo el VPP de la clínica aún menor. En este trabajo evaluamos la utilidad de la ecografía como primera aproximación diagnóstica.Material y método: se han reclutado 79 pacientes (48 varones, edad media 69,3 años). En todos ellos se realiza una ecografía antes de la endoscopia. Se evalúa la precisión en el diagnóstico del cáncer de colon y gástrico, los diagnósticos ecográficos y el número de endoscopias que se evitarían. También se buscan factores predictivos de la localización de la neoplasia.Resultados: se han diagnosticado 5 neoplasias gástricas (6,3%) y 12 de colon (19%), 3 cáncer de páncreas (3,8%), 2 neoplasias uterinas (2,5%) y 2 hipernefromas (2,5%). Las cifras de sensibilidad, especificidad, VPP, VPN y precisión de la ecografía fueron 80%, 98,6%; 80%; 98,6%; y 97,4% respectivamente en el diagnóstico del cáncer gástrico, y del 100%, 94,5%; 80%; 100% y 95,5% respectivamente en el diagnóstico del cáncer de colon. La ecografía permitió evitar el 10% de las endoscopias. El único dato que orienta la localización de la neoplasia es la presencia de anemia, que se asocia con mayor frecuencia al diagnóstico de cáncer de colon: 30,4 versus 4,3% (p = 0,033).Conclusiones: en los pacientes remitidos para descartar una neoplasia digestiva, con síntomas inespecíficos, se diagnostica con frecuencia de patología neoplásica ajena al tubo digestivo. Si consideramos, además, la elevada precisión diagnóstica de la ecografía, esta podría ser una muy buena primera aproximación diagnóstica.Palabras clave: Cáncer de colon. Cáncer gástrico. Ecografía. Diagnóstico. Precisión. Utilidad. ABSTRACTBackground: the Positive Predictive Value (PPV) of signs and symptoms for the diagnosis of colon and gastric cancer is low. Furthermore, many patients are referred to us to discard a digestive tract neoplasm with no symptoms suggestive of its whereabouts, in whom clinical PPV is even lower. This study evaluates the usefulness of ultrasonography as a first approach to diagnosis.Material and methods: seventy-nine patients were recruited into the study (48 males with an average age of 69.3 years). Ultrasonography was performed on all patients prior to endoscopy. Parameters studied included diagnostic accuracy for colon and gastric cancer, ultrasonographic diagnoses, and number of endoscopies that can be avoided. Predictive factors for neoplasm location were also studied.Results: five gastric cancers (6.3%), 12 colon cancers (15,1%), 3 pancreatic cancers (3.8%), 2 uterine neoplasms (2.5%), and 2 hypernephromas (2.5%) were diagnosed. The figures for sensitivity, specificity, PPV, Negative Predictive Value (NPV) and global accuracy of ultrasonography were 80%, 98.6%, 80%, 98.6%, and 97.4%, respectively, for gastric cancer, while these figures were 100%, 94.5%, 80%, 100%, and 95.5%, respectively, for...

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“…The sensitivity obtained by ultrasonography in the diagnosis of colon cancer is comparable to that of barium enema, which can have certain limitations when evaluating the right colon (23)(24)(25)(26). On the other hand, Rutgeerts et al (10), and Grunshow et al (15) concluded that ultrasonography sensitivity is greater in this segment of the colon. In our series, 100% of right colon lesions identified were diagnosed through ultrasonography.…”

Section: Esquema Representativo De La Localización De Los Tumores De mentioning

confidence: 95%

Ultrasonography is an accurate technique for the diagnosis of gastrointestinal tumors in patients without localizing symptoms

Martı́nez-Ares

Alonso-Aguirre

Souto-Ruzo

et al. 2009

Rev. esp. enferm. dig.

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Prospective Evaluation of Ultrasound in Distal Ileal and Colonic Obstruction

Cited by 28 publications

References 24 publications

Small bowel obstruction: the role of computed tomography in its diagnosis and management with reference to other imaging modalities

Small bowel obstruction: the role of computed tomography in its diagnosis and management with reference to other imaging modalities

Utilidad de la ecografía en el diagnóstico de los pacientes con sospecha de neoplasias del tubo digestivo

Ultrasonography is an accurate technique for the diagnosis of gastrointestinal tumors in patients without localizing symptoms

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