Pal Nilkanth L, Panandiker Swamini D, Katiyar Glory, Vernekar Jeevan A
Department of Radio-diagnosis, Goa Medical College, Bambolim, Goa, 403 202, India.
Emerg Radiol. 2024 Oct;31(5):733-748. doi: 10.1007/s10140-024-02256-8. Epub 2024 Jun 27.
Intestinal obstruction is a common surgical emergency with high morbidity and mortality. Patients presenting with features of small bowel obstruction need urgent evaluation to avoid complications such as bowel gangrene, perforation, or peritonitis. Imaging is necessary in most cases of suspected bowel obstruction, to take an appropriate decision, for apt patient management. Among the common causes of small bowel obstruction, adhesions, external herniae, malignancies, and Crohn's disease top the chart. Imaging helps in determining the presence of obstruction, the severity of obstruction, transition point, cause of obstruction, and associated complications such as strangulation, bowel gangrene, and peritonitis. This review is based on the cases with unusual causes of bowel obstruction encountered during our routine practice and also on the extensive literature search through the standard textbooks and electronic databases. Through this review we want our readers to have sound knowledge of the imaging characteristics of the uncommon yet important causes of bowel obstruction. We have also revisited and structured a checklist to simplify the approach while reporting a suspected case of small bowel obstruction. Imaging plays a key role in the diagnosis of small bowel obstruction and in determining the cause and associated complications. Apart from the common causes of small bowel obstruction, we should also be aware of the uncommon causes of small bowel obstruction and their imaging characteristics to make an accurate diagnosis and for apt patient management.
肠梗阻是一种常见的外科急症，发病率和死亡率都很高。出现小肠梗阻症状的患者需要紧急评估，以避免诸如肠坏疽、穿孔或腹膜炎等并发症。在大多数疑似肠梗阻的病例中，影像学检查对于做出恰当决策、进行合理的患者管理是必要的。小肠梗阻的常见病因中，粘连、外部疝、恶性肿瘤和克罗恩病位居前列。影像学检查有助于确定是否存在梗阻、梗阻的严重程度、移行点、梗阻原因以及诸如绞窄、肠坏疽和腹膜炎等相关并发症。本综述基于我们日常实践中遇到的病因不寻常的肠梗阻病例，以及通过标准教科书和电子数据库进行的广泛文献检索。通过本综述，我们希望读者对肠梗阻不常见但重要的病因的影像学特征有充分的了解。我们还重新审视并构建了一份清单，以简化报告疑似小肠梗阻病例时的检查方法。影像学在小肠梗阻的诊断以及确定病因和相关并发症方面起着关键作用。除了小肠梗阻的常见病因外，我们还应了解小肠梗阻的不常见病因及其影像学特征，以便做出准确诊断并进行合理的患者管理。
