The early diagnosis of small-bowel obstruction is critical in preventing complications, particularly strangulation. Traditionally, the clinical diagnosis of small-bowel obstruction has depended on plain film confirmation. Unfortunately, findings on the plain film may not be confirmatory in 20-52% of cases. The purpose of this study was to determine whether CT is superior to the traditional clinical-radiographic evaluation in prospectively establishing the diagnosis, severity, and cause in cases of suspected obstruction of the small bowel and to see what impact this information might have on treatment, costs, and the need for additional gastrointestinal contrast studies.Physicians from three surgical services referred all patients with suspected small-bowel obstruction for plain film and CT evaluation. Eight-five patients were evaluated on 90 occasions during an 11-month period. Obstruction was classified on the basis of clinical and plain film findings as absent, indeterminate, or present (partial or comp...