학술논문
Diagnosis of Non-necrotic Small Bowel Strangulation Using Contrast Enhanced CT / 造影CTによる非壊死性絞扼性腸閉塞の診断
Document Type
Journal Article
Author
Akihisa Matsuda; Goro Takahashi; Hiroshi Yoshida; Keisuke Hara; Koji Ueda; Koki Takeda; Masahiro Hotta; Michihiro Koizumi; Satoshi Matsumoto; Seiichi Shinji; Sho Kuriyama; Takeshi Yamada; Takuma Iwai; Yasuyuki Yokoyama; Yuto Aoki; 上田 康二; 原 敬介; 吉田 寛; 堀田 正啓; 小泉 岐博; 山田 岳史; 岩井 琢磨; 松本 智司; 松田 明久; 栗山 翔; 横山 康行; 武田 幸樹; 進士 誠一; 青木 悠人; 高橋 吾郎
Source
日本腹部救急医学会雑誌 / Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine). 2018, 38(6):959
Subject
Language
Japanese
ISSN
1340-2242
1882-4781
1882-4781
Abstract
【Background】The pathogenesis of small bowel strangulation (SBS) is a bowel blood─flow disorder, and non-necrotic SBS is SBS with an incomplete blood-flow disorder. Contrast enhanced CT (CECT) is promising for the diagnosis. However, it remains unclear which findings of CECT are useful for the diagnosis of non-necrotic SBS. 【Methods】Study patients included 29 patients with necrotic SBS and 48 patients with non-necrotic SBS. 【Results】We found intestinal wall thickness and mesenteric edema in over 70％ of the patients with both necrotic and non-necrotic SBS. Disappearance of Kerckring’s folds, bowel hypoenhancement and hemorrhagic ascites were identified as independent risk factors indicating necrotic SBS. Hypoenhancement of the bowel wall was found in 55％ of patients with necrotic SBS and 4％ of non-necrotic SBS. 【Discussion】For accurate diagnosis of non-necrotic SBS, we should pay attention not so much to hypoenhancement of the bowel wall but bowel wall thickness and mesenteric edema.