Département de radiologie, Hôpital Saint-Luc, Centre Hospitalier Universitaire de Montréal (CHUM), 1058 rue Saint-Denis, Montréal, Québec, Canada H2X 3J4.
Eur J Radiol. 2010 Apr;74(1):60-6. doi: 10.1016/j.ejrad.2009.11.010. Epub 2009 Dec 16.
Small and large bowel volvulus are uncommon causes of bowel obstruction with nonspecific clinical manifestations which may delay the diagnosis and increase morbidity. Therefore, radiologists play an important role in promptly establishing the diagnosis, recognizing underlying congenital or acquired risk factors and detecting potentially life-threatening complications. Multidetector CT performed with intravenous contrast is currently the preferred modality for the evaluation of volvulus, which is best appreciated when imaging is perpendicular to the axis of bowel rotation, hence the benefit of multiplanar reformations. In this pictorial essay we review the pathophysiology of the different types of intestinal volvulus, discuss diagnostic criteria for prompt diagnosis of volvulus and emphasize early recognition of the complications.
小肠和大肠扭转是肠梗阻的不常见原因，其临床表现无特异性，可能会延迟诊断并增加发病率。因此，放射科医生在及时确定诊断、识别潜在的先天性或获得性危险因素以及检测潜在危及生命的并发症方面发挥着重要作用。目前，多排螺旋 CT 静脉造影是评估扭转的首选方式，当成像与肠旋转轴垂直时，最能观察到肠扭转，因此多平面重建具有优势。在本文中，我们回顾了不同类型肠扭转的病理生理学，讨论了快速诊断扭转的诊断标准，并强调了对并发症的早期识别。
