Digestive System Research Unit, University Hospital Vall d'Hebron, Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (Ciberehd), Barcelona, Spain.
Neurogastroenterol Motil. 2013 Jun;25(6):e389-94. doi: 10.1111/nmo.12128. Epub 2013 Apr 22.
We previously showed that abdominal distension in patients with functional gut disorders is due to a paradoxical diaphragmatic contraction without major increment in intraabdominal volume. Our aim was to characterize the pattern of gas retention and the abdomino-thoracic mechanics associated with abdominal distension in patients with intestinal dysmotility.
In 15 patients with manometrically proven intestinal dysmotility, two abdominal CT scans were performed: one during basal conditions and other during an episode of severe abdominal distension. In 15 gender- and age-matched healthy controls, a basal scan was performed.
In basal conditions, patients exhibited more abdominal gas than healthy subjects, particularly in the small bowel, and the volume significantly increased during an episode of distension. During episodes of abdominal distension, the increase in abdominal content was associated with increased girth and antero-posterior abdominal diameter, as well as a cephalic displacement of the diaphragm, which reduced the height of the lung. The consequent reduction in the air volume of the lung was attenuated by an increase in the antero-posterior diameter of the chest.
CONCLUSIONS & INFERENCES: Abdominal distension in patients with severe intestinal dysfunction is related to marked pooling of gut contents, particularly in the small bowel. This increase in content is accommodated within the abdominal cavity by a global and coordinated abdomino-phreno-thoracic response, involving an accommodative ascent of the diaphragm and a compensatory expansion of the chest wall.
我们之前发现，功能性肠道疾病患者的腹胀是由于膈矛盾性收缩引起的，而不是由于腹腔内容积的明显增加。我们的目的是描述肠动力障碍患者腹胀时气体潴留的模式和腹胸力学特征。
在 15 例经测压证实的肠动力障碍患者中，进行了两次腹部 CT 扫描：一次在基础状态下，另一次在严重腹胀发作时。在 15 名性别和年龄匹配的健康对照者中，进行了基础扫描。
在基础状态下，患者的腹部气体比健康受试者多，特别是在小肠，并且在腹胀发作时显著增加。在腹胀发作期间，腹部内容物的增加与腰围和腹前后径的增加以及膈的头侧移位有关，这会降低肺的高度。胸腔前后径的增加减轻了肺容量的减少。
严重肠道功能障碍患者的腹胀与明显的肠道内容物积聚有关，特别是在小肠。这种内容物的增加通过腹部、膈和胸廓的整体协调反应来适应腹腔，包括膈的适应性上升和胸壁的代偿性扩张。
