The Comparative Study Between MSCT Imaging And The Clinic Of Intestinal Obstruction Due To Abdominal Internal Hernia

Intestinal obstruction caused by abdominal internal hernia is the mainreason of intestinal obstruction-borne hernia，acute onset，rapid progression，and dangerous condition，it is diffcult for clinical diagnosis in early stage.Therefore its early diagnosis has important clinical significance.Objective: To explore imaging findings of the multi-slice spiral CT of theintestinal obstruction caused by abdominal internal hernia and itscomplications.Subjects and Methods:Retrospective review of48patients of intestinalobstruction caused by abdominal internal hernia with MSCT and was provedby surgery from September2009to March2012in the hospital. There are23male and25female, ranged from14to87years old, the average age of48.3years.41cases had previous abdominal surgery.Patients were all sudden onsetand their performance of abdominal pain which was persistent or paroxysmalincrease,stop with discharge and bowel movements stop or nausea, vomiting,and other acute intestinal obstruction.43patients received emergencyexamination with unenhanced MSCT scan and others received bothunenhanced and enhanced MSCT scans, and they were scaned by Siemensdual-source CT.80-100ml non-ionic contrast media omnipaque(370mg/l) orultavist(350mg/l) was injected by automatic high pressure injector at a speed of3.5ml/s. The delay time of arterial phase,venous phase and balance phase were29s、40s and80s after injected, respectively. Scan range: including the entireobdomen, holding breath. Scanning parameters: collimation64×0.625, slicethickness5mm, slice distance5mm，table speed12mm/s, tube voltage120KV,tube current260-320mAs,rotation time0.7s. The original scanning data was reconstructed to1mm thickness, including the coronal and sagittal images, thentransmitted to the workstation and observed in abdomen window withcombination of axial images, multiplanar reconstruction(MPR)， volumerendering(VR), maximum intensity projection(MIP), maximum intensityprojection thin(MIP thin). What to observe were that the approximate site ofintestinal obstruction caused by abdominalinternal hernia, whether there wereexistence of strangulation and changes of intestinal wall, mesentery, mesentericcorresponding blood vessels, and peritoneum. Summary MSCT findings ofintestinal obstruction and its complications which caused by abdominal herniain order to provide a reliable basis for clinical diagnosis and treatment.Results：I retrospective review of48patients of intestinal obstructioncaused by abdominal internal hernia with MSCT and was proved by surgery. Inwhich1cases is Transomental hernia,1case is Transmesenteric herina, the rest46cases are abdominal internal hernia due to adhesions.Conclusion: The examination of intestinal obstruction caused byabdominal intrernal hernia with MSCT can provide satisfied images. Diagnosisof intestinal obstruction caused by abdominal internal hernia can be faster andmore accurate. What to observe were that the approximate site of intestinalobstruction caused by abdominalinternal hernia, whether there were existenceof strangulation and changes of intestinal wall, mesentery, mesentericcorresponding blood vessels, and peritoneum can get a better display, which is.practical and reliable diagnosis method for intestinal obstruction caused byabdominal intrernal hernia...