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多层螺旋计算机断层扫描在肠梗阻评估与管理中的作用

Role of multislice computed tomography in evaluation and management of intestinal obstruction.

作者信息

Saini Durgesh Kumar, Chaudhary Poras, Durga Chikkala Kanak, Saini Kiran

机构信息

Post graduate Institute of Medical Education and Research, Dr Ram Manohar Lohia Hospital (Dr RMLH and PGIMER) , New Delhi, India.

出版信息

Clin Pract. 2013 Jun 28;3(2):e20. doi: 10.4081/cp.2013.e20. eCollection 2013 Aug 2.

Abstract

i) to evaluate the efficacy of computed tomography (CT) imaging in diagnosing the presence, level, degree, and cause of intestinal obstruction, and the role of CT in detecting presence of complications; ii) to assess impact of CT in decision making and management (surgical/conservative); iii) to correlate CT findings with intra operative findings whenever possible. A prospective study of 40 patients presented in outpatient/emergency department with features suggestive of intestinal obstruction. Multislice contrast enhanced computed tomography of whole abdomen was done in all patients after preliminary investigations. Whenever indicated, patients were explored. Statistical analysis was performed to determine the efficacy of multidetector computed tomography (MDCT) in diagnosing intestinal obstruction and its complications. Out of 40, 30 patients underwent exploratory laparotomy and it was found that MDCT was 85% sensitive and 70% specific in diagnosing bowel obstruction. Association between MDCT findings suggestive of obstruction and intra-operative findings turn out to be significant (P=0.003). MDCT findings were consistent with intraoperative findings in 22 out of 30 patients (73%). MDCT is sensitive and specific in determining the presence of bowel obstruction and should be recommended for patients with suspected bowel obstruction because it affects outcome in these patients.

摘要

i) 评估计算机断层扫描(CT)成像在诊断肠梗阻的存在、部位、程度及病因方面的效能,以及CT在检测并发症存在情况中的作用;ii) 评估CT在决策制定及管理(手术/保守治疗)中的影响;iii) 尽可能将CT检查结果与术中发现进行对比分析。对40例在门诊/急诊科就诊、具有肠梗阻特征的患者进行了一项前瞻性研究。所有患者在初步检查后均接受了全腹部多层增强计算机断层扫描。如有指征,对患者进行探查。进行统计分析以确定多排螺旋计算机断层扫描(MDCT)在诊断肠梗阻及其并发症方面的效能。40例患者中,30例接受了剖腹探查术,结果发现MDCT诊断肠梗阻的敏感性为85%,特异性为70%。MDCT提示梗阻的检查结果与术中发现之间的关联具有显著性(P = 0.003)。30例患者中有22例(73%)的MDCT检查结果与术中发现一致。MDCT在确定肠梗阻的存在方面具有敏感性和特异性,对于疑似肠梗阻的患者应推荐使用,因为它会影响这些患者的治疗结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a495/3981259/63cedb9354b7/cp-2013-2-e20-g001.jpg

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