Computed tomography value ascites and mesenteric fluid predict intestinal necrosis in strangulated small bowel obstruction

Abstract The preoperative diagnosis of intestinal necrosis in strangulated small-bowel obstruction (SBO) is clinically important because it is prognostically relevant. The current study assessed the predictors of preoperative intestinal necrosis in strangulated SBO. This retrospective single-center...

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Main Authors: Toshiyuki Suzuki, Akiyo Matsumoto, Daisuke Sugiki, Takahiko Akao, Hiroshi Matsumoto
Format: Article
Language:English
Published: Nature Portfolio 2025-07-01
Series:Scientific Reports
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Online Access:https://doi.org/10.1038/s41598-025-13186-x
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author Toshiyuki Suzuki
Akiyo Matsumoto
Daisuke Sugiki
Takahiko Akao
Hiroshi Matsumoto
author_facet Toshiyuki Suzuki
Akiyo Matsumoto
Daisuke Sugiki
Takahiko Akao
Hiroshi Matsumoto
author_sort Toshiyuki Suzuki
collection DOAJ
description Abstract The preoperative diagnosis of intestinal necrosis in strangulated small-bowel obstruction (SBO) is clinically important because it is prognostically relevant. The current study assessed the predictors of preoperative intestinal necrosis in strangulated SBO. This retrospective single-center study included 75 consecutive patients undergoing surgery for strangulated SBO. Patients with inguinal, femoral, and obturator hernia were excluded from the analysis. The computed tomography (CT) attenuation value in Hounsfield units (HU) of the strangulated bowel was calculated as the average of the CT attenuation values in HU ​​of the bowel contents measured at three random points. The patients were divided into the intestinal necrosis and without necrosis groups. Clinical and CT scan findings were retrospectively analyzed, and univariate and multivariate analyses were performed. The cutoff CT attenuation value in HU was the mean value. In total, 37 patients presented with intestinal necrosis in the strangulated SBO and 38 did not. In the univariate analysis, strangulated SBO, massive ascites, and mesenteric fluid, which had CT attenuation values ≥ 20 HU, were significant predictors of preoperative bowel necrosis. These factors were also independent predictors of preoperative intestinal necrosis in strangulated SBO in the multivariate analysis. Thus, these factors may help in predicting and managing necrosis in strangulated SBO.
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spelling doaj-art-a961bde96f2b477a93a703ea7a3ab89f2025-08-20T03:46:08ZengNature PortfolioScientific Reports2045-23222025-07-011511710.1038/s41598-025-13186-xComputed tomography value ascites and mesenteric fluid predict intestinal necrosis in strangulated small bowel obstructionToshiyuki Suzuki0Akiyo Matsumoto1Daisuke Sugiki2Takahiko Akao3Hiroshi Matsumoto4Department of Surgery, Hanyu General HospitalDepartment of Surgery, Hanyu General HospitalDepartment of Emergency and Critical Care Medicine, Emergency and Critical Care Center, Dokkyo Medical University Saitama Medical CenterDepartment of Surgery, Hanyu General HospitalDepartment of Surgery, Hanyu General HospitalAbstract The preoperative diagnosis of intestinal necrosis in strangulated small-bowel obstruction (SBO) is clinically important because it is prognostically relevant. The current study assessed the predictors of preoperative intestinal necrosis in strangulated SBO. This retrospective single-center study included 75 consecutive patients undergoing surgery for strangulated SBO. Patients with inguinal, femoral, and obturator hernia were excluded from the analysis. The computed tomography (CT) attenuation value in Hounsfield units (HU) of the strangulated bowel was calculated as the average of the CT attenuation values in HU ​​of the bowel contents measured at three random points. The patients were divided into the intestinal necrosis and without necrosis groups. Clinical and CT scan findings were retrospectively analyzed, and univariate and multivariate analyses were performed. The cutoff CT attenuation value in HU was the mean value. In total, 37 patients presented with intestinal necrosis in the strangulated SBO and 38 did not. In the univariate analysis, strangulated SBO, massive ascites, and mesenteric fluid, which had CT attenuation values ≥ 20 HU, were significant predictors of preoperative bowel necrosis. These factors were also independent predictors of preoperative intestinal necrosis in strangulated SBO in the multivariate analysis. Thus, these factors may help in predicting and managing necrosis in strangulated SBO.https://doi.org/10.1038/s41598-025-13186-xCT attenuation value in hounsfield unitsAscitesMesenteric fluidStrangulated small-bowel obstructionCT findings
spellingShingle Toshiyuki Suzuki
Akiyo Matsumoto
Daisuke Sugiki
Takahiko Akao
Hiroshi Matsumoto
Computed tomography value ascites and mesenteric fluid predict intestinal necrosis in strangulated small bowel obstruction
Scientific Reports
CT attenuation value in hounsfield units
Ascites
Mesenteric fluid
Strangulated small-bowel obstruction
CT findings
title Computed tomography value ascites and mesenteric fluid predict intestinal necrosis in strangulated small bowel obstruction
title_full Computed tomography value ascites and mesenteric fluid predict intestinal necrosis in strangulated small bowel obstruction
title_fullStr Computed tomography value ascites and mesenteric fluid predict intestinal necrosis in strangulated small bowel obstruction
title_full_unstemmed Computed tomography value ascites and mesenteric fluid predict intestinal necrosis in strangulated small bowel obstruction
title_short Computed tomography value ascites and mesenteric fluid predict intestinal necrosis in strangulated small bowel obstruction
title_sort computed tomography value ascites and mesenteric fluid predict intestinal necrosis in strangulated small bowel obstruction
topic CT attenuation value in hounsfield units
Ascites
Mesenteric fluid
Strangulated small-bowel obstruction
CT findings
url https://doi.org/10.1038/s41598-025-13186-x
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AT daisukesugiki computedtomographyvalueascitesandmesentericfluidpredictintestinalnecrosisinstrangulatedsmallbowelobstruction
AT takahikoakao computedtomographyvalueascitesandmesentericfluidpredictintestinalnecrosisinstrangulatedsmallbowelobstruction
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