Di Saverio Salomone, Tugnoli Gregorio, Ansaloni Luca, Catena Fausto, Biscardi Andrea, Jovine Elio, Baldoni Franco
Department of Surgery and Emergency, Maggiore Hospital Trauma Center, University of Bologna, Bologna, Italy.
BMJ Case Rep. 2010 Nov 12;2010:bcr0820092177. doi: 10.1136/bcr.08.2009.2177.
A 78-year-old man presented to the casualty department, complaining of recurrent and worsening constipation for the previous 2 months. This was associated with central, colicky abdominal pain and melena. In the last days, the symptoms worsened and the patient became partially obstructed, with nausea, vomiting and passing flatus but not stools for 72 h. The past medical history was unremarkable. The radiological findings of the plain abdominal film were consistent with mechanical small-bowel obstruction. CT scan revealed an intraluminal mass in the small bowel, which drew attention away from gross thickening of the caecal wall that was also present. A careful review of the images should not be omitted. One must be aware of a polymorphous appearance and the multiple causes of intestinal obstruction and avoid underestimating even the minor and less evident radiological findings.
一名78岁男性因前两个月反复出现且逐渐加重的便秘症状前往急诊室就诊。这伴有中腹部绞痛和黑便。在过去几天里，症状加重，患者出现部分肠梗阻，伴有恶心、呕吐，72小时未排气排便。既往病史无特殊。腹部平片的影像学表现与机械性小肠梗阻相符。CT扫描显示小肠腔内有一肿块，同时盲肠壁明显增厚也引起了注意。不应忽略对图像的仔细观察。必须意识到肠梗阻的多样表现和多种病因，即使是轻微且不太明显的影像学表现也不能低估。
