Umphrey Heidi, Canon Cheri L, Lockhart Mark E
Department of Radiology, JTN358, University of Alabama at Birmingham, 619 19th Street South, Birmingham, AL 35249-6830, USA.
Radiol Clin North Am. 2008 Sep;46(5):943-52, vi-vii. doi: 10.1016/j.rcl.2008.06.004.
This article presents the differential diagnosis for small bowel ischemia. Clinical presentation of small bowel ischemia is variable, presenting with a myriad of specific or nonspecific clinical and laboratory findings. The imaging findings associated with small bowel ischemia are variable and combinations of findings may be necessary for definitive diagnosis. More specific imaging findings in patients with acute small intestine ischemia include bowel wall gas, mesenteric vessel occlusion, mesenteric venous gas, portal venous gas, or absence of bowel wall enhancement. Less specific imaging findings include small bowel wall thickening, mesenteric stranding, and mesenteric fluid. Further complicating the issue, several small intestinal disease processes may mimic ischemia both clinically and radiographically. These alternate diagnoses include infectious, inflammatory, and infiltrative processes.
本文介绍了小肠缺血的鉴别诊断。小肠缺血的临床表现多样，有大量特异性或非特异性的临床及实验室检查结果。与小肠缺血相关的影像学表现各异，可能需要多种表现相结合才能做出明确诊断。急性小肠缺血患者更具特异性的影像学表现包括肠壁积气、肠系膜血管闭塞、肠系膜静脉积气、门静脉积气或肠壁强化缺失。特异性较低的影像学表现包括小肠壁增厚、肠系膜条索状影和肠系膜积液。使问题更加复杂的是，一些小肠疾病在临床和影像学上可能与缺血相似。这些其他诊断包括感染性、炎症性和浸润性病变。
