Bsteh O
Radiol Clin (Basel). 1975;44(1):14-23.
Knowledge of the patho-physiological behaviour present in the colon is the deciding factor for a reliable differential diagnosis of mechanical or paralytic ileus. A quick and sure diagnosis can be got with irrigoscopy (barium enema). In paralytic ileus, a radical change in the function of the right colon is present; instead of resorption, exudation and paralysis have taken place. Barium enema shows this behaviour; the left colon stays contracted, the contrast medium passes easily into the right colon, where it mixes with the fluid levels. This picture is proof of paralytic ileus. A completely different picture is to be found in mechanical ileus of the small intestine; the small intestine is gas-inflated, with fluid levels, and passes nothing on to the colon which, therefore, is contracted in its whole length. This picture also is diagnostic. Barium enema is already known in the diagnosis of mechanical ileus of the large intestine. It can also be used in the diagnosis of paralytic enterocolitis (without diarrhoea) in childhood and old age. In the case of post-operative early ileus it gives a quick and sure differential diagnosis.
了解结肠中存在的病理生理行为是可靠鉴别诊断机械性或麻痹性肠梗阻的决定性因素。通过灌肠造影（钡灌肠）可以快速准确地做出诊断。在麻痹性肠梗阻中，右半结肠功能发生根本性改变；不是吸收，而是出现了渗出和麻痹。钡灌肠显示出这种情况；左半结肠保持收缩状态，造影剂很容易进入右半结肠，并与液平面混合。这种影像可证明是麻痹性肠梗阻。在小肠机械性肠梗阻中则呈现完全不同的影像；小肠充气并伴有液平面，没有任何东西进入结肠，因此结肠全长收缩。这种影像也具有诊断意义。钡灌肠在大肠机械性肠梗阻的诊断中已为人所知。它还可用于儿童和老年人麻痹性小肠结肠炎（无腹泻）的诊断。对于术后早期肠梗阻，它能快速准确地进行鉴别诊断。
