Scintigraphic Evaluation of Small Bowel Obstruction

Objective: To determine the feasibility of hepatobiliary iminodiacetic acid in the evaluation of small bowel obstruction in adults. Patients and Methods: This was a pilot study of the feasibility of technetium 99m hepatobiliary iminodiacetic acid in the evaluation of small bowel obstruction. A total of 8 patients clinically suspected to have small bowel obstruction were recruited in this study from November 2002 to July 2004. Correlation with water-soluble follow-through study and clinical outcome of the patients was evaluated. Results: A total of 8 patients had hepatobiliary iminodiacetic acid scan for small bowel obstruction; 5 patients had follow-through examination. Of 4 patients with delayed small bowel transit time shown on small bowel hepatobiliary iminodiacetic acid scan, 3 had surgery with the final operative diagnosis of gallstone ileus or intestinal adhesions and 1 was too frail for operation (with the intestinal obstruction diagnosed on small bowel hepatobiliary iminodiacetic acid scan only), but responded to conservative treatment. Four patients had normal small bowel transit time and were managed conservatively with uneventful clinical outcome. Conclusions: Preliminary results show that hepatobiliary iminodiacetic acid study is feasible in the evaluation of small bowel obstruction in adults. The initial results are promising, correlating with those of the followthrough study. In selected patients, hepatobiliary iminodiacetic acid small bowel transit scan can potentially serve as an alternative to follow-through in the investigation of small bowel obstruction.