Efficacy of measuring non-contrast CT attenuation of incarcerated intestines with obturator hernias for determination of resection

Purpose: The aim of the study was to investigate the efficacy of measuring non-contrast CT attenuation (Hounsfield Unit; HU) of incarcerated intestines with obturator hernias for determination of resection. Materials and Methods: Twenty-three patients (24 lesions), with a diagnosis of intestinal obstruction with obturator hernia at our hospital were enrolled in this study. The CT attenuations were measured at the following three points, 1) luminal contents of the incarcerated intestinal tract, 2) incarcerated intestinal wall of the fundus, and 3) incarcerated intestinal wall of the neck. The lesions were classified into 11 types in the intestinal resection group and 13 types in the non-resection group. The average CT attenuations between the two groups were compared by statistical methods. The criterion of intestinal resection was macroscopic necrosis or perforation of the incarcerated intestines. Results: The average CT attenuation of the incarcerated intestinal wall at the fundus was 17.61±10.57 HU in the resection group and 27.41±12.98 HU in the non-resection group. Significant differences were observed between the two groups by univariate (P < 0.05) and multivariate analyzes (P < 0.05). The cut-off value prediction value of intestinal resection was 27 HU according to the examination of the receiver operator characteristic (ROC) curve. There were no significant differences between the two groups in the average CT attenuation of the other sites. Conclusion: Measuring noncontrast CT attenuation of the incarcerated intestinal wall at the fundus was necessary in determining whether resection of the incarcerated intestine with obturator hernia was required.