The usefulness of Computed Tomography (CT) in the preoperative diagnosis of strangulation of the intestine was evaluated. Among operated cases of strangulation of the intestine in a period from 1988 to 1991, 30 cases undergoing CT preoperatively were subjected to this study, and physical findings, laboratory data, and CT findings were evaluated by dividing them into intestine resected group (18 cases) and non-resected group (12 cases).
As to physical findings and laboratory data, the incidence of high fever or peritoneal sign was not so high, but hypoactive bowel sound, dysuria, and impaired renal function were observed in a high incidence. However, any specific findings indicating the strangulation of the intestine were lacked.
CT demonstrated many characteristic findings of the strangulation, such as collection of ascites, thickened bowel wall, and mesenteric edema. These findings occurred in a significantly higher incidence in the resected group. Intramural gas seemed very important for the sign of bowel infarction. We were able to diagnose the localization of strangulation in 66.7% of all cases by very characteristic signs, which are “whirl sign”, “torsion of the bowel around the mesenteric axis” and “incarcerated internal hernia”.