Abstract
In order to evaluate the efficacy of CT scanning in preoperative diagnosis of strangulated obstruction of the small intestine, 27 cases of small bowel obstruction treated during a 5year-and-1 month period from Feb. 1990 to Mar. 1995 were retrospectively reviewed.
We defined the strangulated ileus as two types (rotation type and closed type) with small bowel obstruction at two points and circulatory disturbance of the mesenterium, and the simple ileus as without circulatory disturbance of the mesenterium.
We compared the CT findings of the former 14 cases with that of the latter 13 cases for operative results, and other findings.
The characteristic features of strangulated ileus were:
1) disappearance of the Kerckring's folds; 2) blurred enhancement of the intestinal wall; 3) radial distribution of dilated, fluid-filled bowel loops with mesenteric vascular structures converging toward the point of obstruction; 4) thickened mesenterium with increased density; 5) Whirl sign in rotation type; and 6) ascites.
CT scanning is very helpful for diagnosing strangulated small bowel obstruction and should be used in deciding operative indication of ileus cases.
