Early Diagnosis for Bowel Strangulation by Using Contrast Enhanced CT

Abstract

Background: Since the pathogenesis of bowel strangulation is bowel ischemia, contrast enhanced CT (CECT) is important for the diagnosis. However, it is unclear which findings of CECT are useful for the diagnosis. Method: Study patients include 15 patients with necrotic bowel strangulation and 25 patients with non-necrotic bowel strangulation. Results: We found mesenteric vascular dilatation, intestinal wall thickness, and the mesenteric edema sign in over 70% of the patients with bowel strangulation. Ascites, lack of contrast enhancement of the intestinal wall, indistinct valves of Kerckring, and the dirty mesenteric fat sign emerged at a higher rate in the patients with necrotic bowel strangulation than in the patients with non-necrotic bowel strangulation. Discussion: To diagnose bowel strangulation with CECT, we should pay attention not so much to the ascites and lack of contrast enhancement of the intestinal wall but to mesenteric vascular dilatation, the intestinal wall thickness, and the mesenteric edema sign.