Maglinte D D, Herlinger H, Nolan D J
Department of Radiology, Methodist Hospital of Indiana, Indianapolis.
Radiology. 1991 May;179(2):383-7. doi: 10.1148/radiology.179.2.2014278.
The obstruction of a segment of bowel at two points results in a closed loop obstruction. Progression to strangulation is not an invariable component of this entity when surgical intervention is delayed. Enteroclysis is increasingly being used to evaluate obstruction of the small intestine. The authors retrospectively analyzed 25 surgically confirmed cases of closed loop obstruction and noted four enteroclysis features suggestive of the diagnosis: (a) crossing defects obstructing two segments of a loop of bowel secondary to dense adhesive bands (14 patients), (b) focal fixation of two limbs or twisting of the folds at the point of obstruction suggestive of volvulus (three patients), (c) abdominal wall herniation with obstruction (six patients), and (d) focal intraperitoneal segregation of a loop of bowel with tight obstruction suggestive of internal herniation (two patients). Recognition of the different patterns allows prompt preoperative radiologic diagnosis prior to strangulation.
肠道某一段在两个部位发生梗阻会导致闭袢性肠梗阻。若手术干预延迟，发展为绞窄并非此病症必然会出现的情况。小肠灌肠造影越来越多地用于评估小肠梗阻。作者回顾性分析了25例经手术证实的闭袢性肠梗阻病例，并指出了四项提示该诊断的小肠灌肠造影特征：（a）致密粘连带导致横跨缺损，阻塞肠袢的两个节段（14例患者），（b）梗阻部位两个肠袢的局灶性固定或皱襞扭转提示存在肠扭转（3例患者），（c）伴有梗阻的腹壁疝（6例患者），以及（d）肠袢局灶性腹膜内分隔伴严重梗阻提示存在内疝（2例患者）。识别不同的模式有助于在绞窄发生前进行术前影像学诊断。
