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Date Published: 16/05/2023
Abstract Views: 780
Views PDF: 231
DOI: https://doi.org/10.51298/vmj.v526i1A.5275
Issue
Vol. 526 No. 1A (2023)
Section
Các bài báo
How to Cite
Nghiêm , P. T. ., & Lê, T. D. T. . (2023). CT FEATURES OF SMALL BOWEL NECROSIS DUE TO STRANGULATED BOWEL OBSTRUCTION AND ACUTE OCCLUSIVE MESENTERIC ISCHEMIA. Vietnam Medical Journal, 526(1A). https://doi.org/10.51298/vmj.v526i1A.5275

CT FEATURES OF SMALL BOWEL NECROSIS DUE TO STRANGULATED BOWEL OBSTRUCTION AND ACUTE OCCLUSIVE MESENTERIC ISCHEMIA

Phương Thảo Nghiêm 1,, Thị Diễm Trang Lê1
1 Pham Ngoc Thach University of Medicine

Main Article Content

Abstract

Objectives: The purpose of this study was to desribe and compare computed tomography features of small bowel necrosis (SBN) due to strangulated bowel obstruction (SBO) and acute oclusive mesenteric ischemia (AMI). Methods: cross-sectional, retrospective description study. All patients with a pathological diagnosis of small bowel necrosis were diagnosed and operated in Binh Dan hospital from January 1, 2017 to August 31, 2022. Results: there were 40 cases of SBN, including 20 cases (50%) of SBO, 13 cases (32,5%) of venous occlusion AMI and 7 cases (17,5%) of arterial occlusion AMI. The mean age of SBO was 62,30 ± 15,23, of venous occlusion AMI was 59,85± 17,25, of arterial occlusion AMI was 56,57± 14,33. Female predominance was found in SBO group (60%) while male predominance in venous occlusion AMI (69,23%) and arterial occlusion AMI (100%). Most of patiens SBO had bowel dilatation. Bowel wall thickening and pontanenous hyperattenuation of the bowel wall in venous occlusion AMI (100% and 61,5%, respectively) were significalive higher than in SBO (60% and 55%, respectively) and in arterial occulusion AMI (28,6% and 0%, respectively). Pneumoperitoneum, pneumatosis intestinalis, portal venous gas were uncommon CT features of SBN. Free peritoneal fluid was prominent in venous occlusion AMI (100%), mesenteric fat accounted for the highest percentage in both SBO and venous occlusion AMI (100%) while  bowel wall enhancement was absent in arterial occlusion AMI (85,7%). Conclusion: CT scan has an important role in early diagnosis and helps to differentiate the cause of SBN.

Article Details

Keywords

CT, small bowel necrosis, strangulated bowel obstruction, acute occlusive mesenteric ischemia

References

1. Calame P, Malakhia A, Turco C, Grillet F, Piton G, Delabrousse E. Transmural bowel necrosis from acute mesenteric ischemia and strangulated small-bowel obstruction: distinctive CT features. American Journal of Roentgenology. 2020;214(1):90-5.
2. Chou CK. CT manifestations of small bowel ischemia due to impaired venous drainage-with a correlation of pathologic findings. The Indian journal of radiology & imaging. 2016;26(3):342.
3. Copin P, Zins M, Nuzzo A, Purcell Y, Beranger-Gibert S, Maggiori L, et al. Acute mesenteric ischemia: a critical role for the radiologist. Diagnostic and Interventional Imaging. 2018;99(3):123-34.
4. Lehtimäki TT, Kärkkäinen JM, Saari P, Manninen H, Paajanen H, Vanninen R. Detecting acute mesenteric ischemia in CT of the acute abdomen is dependent on clinical suspicion: review of 95 consecutive patients. European journal of radiology. 2015;84(12):2444-53.
5. Nakashima K, Ishimaru H, Fujimoto T, Mizowaki T, Mitarai K, Nakashima K, et al. Diagnostic performance of CT findings for bowel ischemia and necrosis in closed-loop small-bowel obstruction. Abdominal imaging. 2015; 40(5):1097-103.
6. Nguyễn Duy Hùng, Nguyễn Hoa Huệ, Vương Kim Ngân. Giá trị của cắt lớp vi tính trong chẩn đoán thiếu máu ruột ở bệnh nhân tắc ruột non. Tạp chí Nghiên cứu Y học. 2021;138(2):116-23.
7. Rondenet C, Millet I, Corno L, Boulay-Coletta I, Taourel P, Zins M. Increased unenhanced bowel-wall attenuation: a specific sign of bowel necrosis in closed-loop small-bowel obstruction. European radiology. 2018;28(10):4225-33.
8. Trần Lê Minh Châu. Đặc điểm hình ảnh X quang cắt lớp vi tính thiếu máu ruột do tắc mạch mạc treo tràng trên: Đại học y dược; 2018.
9. Wiesner W, Khurana B, Ji H, Ros PR. CT of acute bowel ischemia. Radiology. 2003;226(3):635-50.
10. Wiesner W, Mortele K. Small bowel ischemia caused by strangulation in complicated small bowel obstruction. ct findings in 20 cases with histo-pathological correlation. drugs. 2011;10:21.