Advantages of Multidetector-Row Computed Tomography for Detecting Transverse Mesocolic Internal Hernia.

IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Le Duc Nam, Thai Khac Trong, Nguyen Van Thach, Le Duy Dung, Lam Sao Mai, Tong Thi Thu Hang
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Abstract

Introduction: A transverse mesocolic internal hernia is a phenomenon in which a small intestinal loop protrudes through the natural orifice in the transverse colon mesentery. This type of internal hernia in adults, although rare, is one of the causes of closed-loop intestinal obstruction, which requires prompt diagnosis and treatment.

Case presentation: We report two cases of transverse mesocolic internal hernia that were examined and subsequently treated at Hospital 108, Hanoi, Vietnam. Both patients (53 and 66 years old) had atypical clinical symptoms, mainly dull epigastric pain. Upon admission, they were initially examined clinically, followed by blood testing and chest and abdominal X-ray radiography. Diagnostic imaging was mainly based on subsequent Multidetector-Row Computed Tomography (MDCT). Laparoscopic/surgical release of the hernia and closure of the natural orifice in the transverse colon mesentery were performed. The clinical symptoms and laboratory and radiographic findings did not suggest a causal diagnosis. However, MDCT provided several images suggestive of an internal hernia, including a closed intestinal loop passing through the transverse colon mesentery and located posteriorly in the left abdominal cavity near the Treitz angle, displacement of the mesenteric vascular bundle, and colon displacement. These displacements were the causes of intestinal inflammation/obstruction. Additionally, laparoscopic/surgical results confirmed the MDCT diagnosis.

Conclusion: Thin-slice thickness, high spatial resolution, multiplanar reconstruction MDCT was effective for diagnosing transverse mesocolic internal hernia. In our two cases, MDCT helped determine the cause and assess the state of intestinal ischemia.

多排探测器计算机断层扫描检测横切性肠系膜内疝的优势。
简介:横结肠肠系膜内疝是一种小肠袢从横结肠肠系膜自然开口突出的现象。这种类型的内疝在成人中虽然罕见,但却是引起闭合性肠梗阻的原因之一,需要及时诊断和治疗。病例介绍:我们报告两例横切性肠系膜内疝,在越南河内108医院检查并随后治疗。两例患者(53岁和66岁)均有不典型临床症状,主要为钝性上腹疼痛。入院后,他们接受了初步的临床检查,随后进行了血液检查和胸部和腹部x线摄影。诊断成像主要基于随后的多行计算机断层扫描(MDCT)。腹腔镜/手术释放疝并关闭横结肠肠系膜的自然口。临床症状、实验室和影像学检查结果未提示病因诊断。然而,MDCT显示了几张提示内疝的图像,包括穿过横结肠肠系膜的封闭肠袢,位于左腹腔后方靠近Treitz角处,肠系膜血管束移位,结肠移位。这些移位是引起肠道炎症/阻塞的原因。此外,腹腔镜/手术结果证实了MDCT诊断。结论:薄层厚度、高空间分辨率、多平面重建的多层螺旋ct对横切型肠系膜内疝有较好的诊断价值。在我们的两个病例中,MDCT有助于确定病因和评估肠缺血状态。
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来源期刊
CiteScore
2.60
自引率
0.00%
发文量
246
审稿时长
1 months
期刊介绍: Current Medical Imaging Reviews publishes frontier review articles, original research articles, drug clinical trial studies and guest edited thematic issues on all the latest advances on medical imaging dedicated to clinical research. All relevant areas are covered by the journal, including advances in the diagnosis, instrumentation and therapeutic applications related to all modern medical imaging techniques. The journal is essential reading for all clinicians and researchers involved in medical imaging and diagnosis.
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