Imagerie des occlusions intestinales hautes de l’adulte

Abstract

For the radiologist, it is a major challenge to answer all the strategy-determining questions raised by surgeons and intensivists faced with an acute abdomen apparently related to high small-bowel obstruction. Although many authors, e.g. Didier Sicard, have deplored the fact that physical examination has become the first complementary exploration ordered after the computed tomography scan, its widespread use in the emergency setting has become an indispensable element for evidence-based decision making. Technique is thus in the forefront. Multiplanar reconstruction, appropriate contrast modulation, and adequate magnification are fundamental, requiring precise well-executed protocols. Detailed analysis of the clinical and imaging findings combined with a thorough understanding of the pathophysiological implications and the statistical limitations is the foundation of the diagnostic reasoning necessary for quality care. Recent advances in imaging techniques concerning intestinomesenteric adhesions and oral gastrographic radiology have improved radiographic performance for high intestinal obstruction in adults.