Intestinal Obstruction Transitional Zone :Preliminary Study With The Characteristics Of CT

Objective: intestinal obstruction is one of the common acute abdomen surgery, accounts for about 20% of acute abdominal pain. Multislice CT scan in combination with the multi-plane reorganization is playing a more and more important role in the diagnosis of intestinal obstruction. In this paper, through a retrospective analysis of the characteristics of patient's transitional belt insufflate multislice CT of different types intestinal obstruction was confirmed by surgery, improve the diagnosis level of different types of CT scan for the intestinal obstruction.Methods: collected 67 cases from January 2013 to September 2014 clinical diagnosis and surgery patient of intestinal obstruction, according to the results of surgery, obstruction can be divided into 6 class, pure mechanical intestinal obstruction, adhesive intestinal obstruction, reverse ileus, paralytic ileus, internal hernia and mixed ileus; analysis detailed of the characteristics of transitional belt insufflate multislice CT scanning in combination with the multi-plane reorganization and the performance of the intestinal canal expansion. 35 cases of male, female 32 cases(the ratio of male and female is close to 1:1), aged from 6 to 92, the average age is 58. all patients was done the multilayer spiral CT scan in combining with multi-plane reorganization, and do surgery 1-3 days after the diagnosis of intestinal obstruction. Results: 67 cases of intestinal obstruction, 28 cases of purely mechanical intestinal obstruction, 17 cases of adhesion intestinal obstruction, 9 cases of paralytic ileus, 5 cases of reverse ileus, 4 cases of internal hernia, 4 cases of mixed intestinal obstruction. 17 cases caused by tumor in 28 cases of simple mechanical intestinal obstruction, including benign and malignant tumor, 2 cases of polyps, 5 cases of abdominal external hernia, 4 cases of small intestinal fecal stone obstruction. 11 cases has a history of surgery in the 17 cases of adhesion intestinal obstruction, 3 cases of appendicitis, 1 case of chocolate cyst, 1 case of tubal infection empyema, 1 case caused by metastatic tumor. 6 cases of appendicitis in 9 cases of paralytic ileus, 1 case of gastrointestinal perforation, 1 case of pancreatitis, 1 case caused by enteritis. 5 cases of torsion ileus. 4 cases of simple intestinal obstruction caused by internal hernias are of transmesenteric hernia.4 cases are mixed intestinal obstruction in this group of cases, 2 cases respectively with intraperitoneal adhesion caused by internal hernias, 2 cases of adhesion intestinal obstruction with volvulus.Conclusion: insufflate transitional belt of the same kind of intestinal obstruction and the surrounding structure has certain characteristics in transitional belt quantity and insufflate form, multilayer spiral CT scanning combined with MRP restructuring can clear display these characteristics. The biggest characteristic in this paper is retrospective analysising of above six type's transition belt loops CT scan features of intestinal obstruction, and summarized. The simple mechanical ileus transitional belt is only one, the blind expanse into a single direction of continuous expansion, transitional belt loops' surface is smooth. Insufflate expansion degree is different, the nearer the transitional belt with the blind expansion, the more obvious, which offers the possibility of fast positioning obstruction transitional belt. Adhesion ileus expansion bowel loops Presents the segmental or continuous expansion, Number of transitional belt is variable, Transitional belt loops present a beak sample change. Reverse ileus, the whirlpool sign or Beak sign in transitional belt is the characteristic of the intestinal obstruction, in this case, turn Angle of about 270 degrees of above. Paralytic ileus can't see the typical transitional belt, blind expansion gradually transit to the normal range, expand insufflate presents into a single direction or continuity or diffuse expansion, degree of expansion can be mixed. Internal hernia caused intestinal obstruction of herniation into the bowel and above blind expansion, degree can be mixed, a pair of beak sample change are visible on the loops above transitional zone, transitional belt loops are with smooth surface, Insufflate shift, The parachute sign are visible when hernia in insufflate mesangial. For the complexity intestinal obstruction, intestinal obstruction, its transitional belt has no fixed characteristics, it is difficult to determine on the CT scan, which has certain difficulty to diagnosis.