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Japanese Journal of Radiology
Published in: Japanese Journal of Radiology 4/2019

01-04-2019 | Computed Tomography | Original Article

Clinical and CT findings of small bowel obstruction caused by rice cakes in comparison with bezoars

Authors: Shigehiro Sugimoto, Taro Shimono, Tohru Takeshita, Akira Yamamoto, Daisuke Shindo, Yukio Miki

Published in: Japanese Journal of Radiology | Issue 4/2019

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Abstract

Purpose

Rice cakes have not been recognized as a cause of small bowel obstruction (SBO) worldwide. We compared clinical and CT findings of rice cake SBO versus SBO due to bezoars, the most common cause of food-induced SBO.

Methods

Twenty-four patients with rice cake SBO (n = 17) or bezoar SBO (n = 7) were retrospectively evaluated for clinical findings and the following multi-detector CT (MDCT) features: identification of the transition zone, presence of intraluminal lesions, degree of obstruction, and length and attenuation of obstructing materials. Categorical variables were compared by Fisher’s exact test, and continuous variables by independent t test.

Results

None of the rice cake SBO patients required surgery, whereas 4/7 (57%) bezoar SBO patients underwent surgery. On MDCT, rice cake residues were recognized as well-defined intraluminal lesions of shorter length (29.8 ± 4.6 mm vs. 47.7 ± 10.8 mm for bezoars; p < 0.0001) and higher attenuation (106 ± 27.8 HU vs. − 62.8 ± 14.7 HU for bezoars; p < 0.0001).

Conclusions

Rice cake SBO patients did not require surgery. On MDCT, rice cake residues were significantly shorter and higher in attenuation than bezoars. These findings facilitate diagnosis and support the conservative management of rice cake SBO.
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Metadata
Title
Clinical and CT findings of small bowel obstruction caused by rice cakes in comparison with bezoars
Authors
Shigehiro Sugimoto
Taro Shimono
Tohru Takeshita
Akira Yamamoto
Daisuke Shindo
Yukio Miki
Publication date
01-04-2019
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 4/2019
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-019-00811-9

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