Martin Lucie C, Merkle Elmar M, Thompson William M
Department of Radiology, Duke University Medical Center, Box 3808, Durham, NC 27710.
AJR Am J Roentgenol. 2006 Mar;186(3):703-17. doi: 10.2214/AJR.05.0644.
Internal hernias, including paraduodenal (traditionally the most common), pericecal, foramen of Winslow, and intersigmoid hernias, account for approximately 0.5-5.8% of all cases of intestinal obstruction and are associated with a high mortality rate, exceeding 50% in some series. To complicate matters, the incidence of internal hernias is increasing because of a number of relatively new surgical procedures now being performed, including liver transplantation and gastric bypass surgery. A significant increase in hernias is occurring in patients undergoing transmesenteric, transmesocolic, and retroanastomotic surgical procedures. It is important for radiologists to be familiar with and to understand the various types of internal hernias and their imaging features so that prompt and accurate diagnosis of these conditions can be made.
This article illustrates the imaging findings of internal hernias, with emphasis placed on the CT findings, especially in transmesenteric, transmesocolic, and retroanastomotic types of internal hernias.
内疝,包括十二指肠旁疝(传统上最常见)、盲肠旁疝、网膜孔疝和乙状结肠间疝,约占所有肠梗阻病例的0.5 - 5.8%,且死亡率较高,在某些系列报道中超过50%。更复杂的是,由于目前正在开展的一些相对较新的外科手术,包括肝移植和胃旁路手术,内疝的发生率正在上升。接受经肠系膜、经结肠系膜和吻合口后手术的患者中疝的发生率显著增加。放射科医生熟悉并了解各种类型的内疝及其影像学特征非常重要,以便能够及时、准确地诊断这些病症。
本文阐述了内疝的影像学表现,重点是CT表现,尤其是经肠系膜、经结肠系膜和吻合口后类型的内疝。