Maglinte D D, Nolan D J, Herlinger H
Department of Radiology, Methodist Hospital of Indiana, Indianapolis 46202.
J Clin Gastroenterol. 1991 Jun;13(3):308-12. doi: 10.1097/00004836-199106000-00011.
Initial observation and evaluation of patient progress have reduced the number of operative interventions in the management of small intestinal obstruction. The differentiation of simple mechanical from strangulating obstructions has remained difficult. Strangulation is not an invariable component of a closed loop obstruction. We report 27 patients with small bowel obstruction initially managed nonsurgically, in whom enteroclysis 2-8 days after admission demonstrated unsuspected closed loop obstruction. In 25 of the 27 patients, subsequent surgery confirmed the radiologic diagnosis: all the obstructed loops were viable and there was no operative mortality. Our experience suggests that the early performance of enteroclysis should be considered in patients with small bowel obstruction undergoing a trial of nonoperative management.
对患者病情的初步观察和评估减少了小肠梗阻治疗中手术干预的次数。单纯机械性梗阻与绞窄性梗阻的鉴别仍然困难。绞窄并非闭环性梗阻的必然组成部分。我们报告了27例最初采用非手术治疗的小肠梗阻患者，入院2 - 8天后的小肠灌肠造影显示存在未被怀疑的闭环性梗阻。27例患者中有25例随后的手术证实了影像学诊断：所有梗阻肠袢均存活，且无手术死亡病例。我们的经验表明，对于接受非手术治疗试验的小肠梗阻患者，应考虑早期进行小肠灌肠造影。
