الفهرس 
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Abstract
One of most common emergencies is intestinal obstruction accounting about 15% of emergency department visits for acute abdominal pain ,it representing either mechanical or functional obstruction of the small or large bowel, which result in impaired passage of it luminal contents. It is considered an important cause of morbidity and mortality. D. C. Oppenheimer et al.(2018)Radiological Imaging plays an important role in the evaluation of suspected bowel obstruction cases and its associated complications, and the potential for morbidity and mortality in these patients .Our study was done on fifty patients with suspected intestinal obstruction, according to our results Out of total 50 patients, 40 patients have provisional diagnosis with MDCT to have intestinal obstruction, 39\40 patients approved..... With statistical analysis, intra-operative findings were matched with MDCT results in 98 % of cases.In 8 patients, there were suggestive signs of ischemia on MDCT scan which confirmed on exploration.Causes of ischemia in these cases were as follow: 6 cases were due to incarcerated hernia complicated with strangulation, one case of superior mesenteric vein thrombus and one case was due to mesenteric vascular occlusion with pneumatosis intestinalis from intramural gas produced by bacteria.In this study main cause of intestinal obstruction in small and large bowel was adenocarcinoma 12 (30.7 %) case was diagnosed with MDCT scan and approved pathologically.Second most common cause is adhesions and incarcerated hernia 6 cases for each one (15.3%), followed by acute pseudo colonic obstruction 5 patients (12.8).4 (10.2 %) cases diagnosed pre-operatively as intussusceptions, three of them have underlying cause (one due to ileo-ileal with lipoma, colico colic with underlying adenocarcinoma and ileal leiomyoma).Small bowel volvulus was a cause of bowel obstruction in one case, on MDCT there was whirl sign which approved intra operative. Gall stone ileus was a cause of bowel obstruction at one case, due to is passage of large stone through the ampulla of Vater into the small bowel, then impacted, in the jejunum, causing SBO.One case diagnosed as active Crohn’s BO, another one case diagnosed as illeus due to peritonitis .Eight cases diagnosed with MDCT as closed loop bowel obstruction six cases were due to incarcerated hernia ,one due to volvulus , and one case due to adhesions ,7/8 approved intra -operatively to have closed loop only one case was simple adhesion not closed loop ..so sensitivity and specificity of multi detector CT in diagnosis of closed loop obstruction in this study is 100% and 96.1 respectivelySensitivity and specificity in this study of MDCT in diagnosis of bowel obstruction were 100% and 91.6 % respectively in all cases, while accuracy is 98%.MDCT can diagnose presence or absence of mechanical obstruction so the decision of doing urgent surgery or only conservative treatment for patients can be made easy.from the present study we can conclude that:•MDCT is accurate in diagnosis presence or absence of bowel obstruction•MDCT can determine cause and site of obstruction.Bowel ischemia is accurately detected with MDCT.•MDCT has crucial role in differentiation between mechanical obstruction and pseudo bowel obstruction, so it helpful in taking decision at management of cases.MDCT is highly recommended in cases with suspected intestinal obstruction.MDCT has high sensitivity in diagnosing special type of bowel obstruction :(Closed loop obstruction).