Nihon Fukubu Kyukyu Igakkai Zasshi (Journal of Abdominal Emergency Medicine)
Online ISSN : 1882-4781
Print ISSN : 1340-2242
ISSN-L : 1340-2242
Diagnosis of Non-necrotic Small Bowel Strangulation Using Contrast Enhanced CT
Takeshi YamadaYuto AokiMichihiro KoizumiSeiichi ShinjiGoro TakahashiTakuma IwaiKoki TakedaYasuyuki YokoyamaMasahiro HottaKeisuke HaraKoji UedaSho KuriyamaAkihisa MatsudaSatoshi MatsumotoHiroshi Yoshida
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2018 Volume 38 Issue 6 Pages 959-963

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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.

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© 2018, Japanese Society for Abdominal Emargency Medicine
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