Diagnosis of Non-necrotic Small Bowel Strangulation Using Contrast Enhanced CT

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  • Yamada Takeshi
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Aoki Yuto
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Koizumi Michihiro
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Shinji Seiichi
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Takahashi Goro
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Iwai Takuma
    Department of Surgery, Nippon Medical School Tama-Nagayama Hospital
  • Takeda Koki
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Yokoyama Yasuyuki
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Hotta Masahiro
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Hara Keisuke
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Ueda Koji
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Kuriyama Sho
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School
  • Matsuda Akihisa
    Department of Surgery, Nippon Medical School Chiba-Hokuso Hosipital
  • Matsumoto Satoshi
    Department of Surgery, Nippon Medical School Chiba-Hokuso Hosipital
  • Yoshida Hiroshi
    Department of Gastrointestinal and Hepato-Billiary-Pancreatic Surgery, Nippon Medical School

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  • 造影CTによる非壊死性絞扼性腸閉塞の診断

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<p>【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.</p>

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