在非旋转的 midgut 的上升冒号的 Volvulus : 平凡电影和 MDCT 调查结果

• 作者: Giovanni Persico Luigi Camera Marco Salvatore Milena Calabrese Pier Paolo Mainenti Stefania Masone Walter Del Vecchio
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: COLONIC VOLVULUS Intestinal MALROTATION Abdominal plain film Multi-detector computed tomography Large bowel obstruction
• 年，卷（期）: 2012,（10）
• 页码范围: 439-442
• 页数: 4页
• 分类号: R574

摘要

Colonic volvulus is a relatively uncommon cause of large bowel obstruction usually involving mobile,intraperitoneal,colonic segments.Congenital or acquired anatomic variation may be associated with an increased risk of colonic volvulus which can occasionally involve retro-peritoneal segments.We report a case of 54-year-old female who presented to our Institution to perform a plain abdominal film series for acute onset of cramping abdominal pain.Both the upright and supine films showed signs of acute colonic obstruction which was thought to be due to an internal hernia of the transverse colon into the lesser sac.The patient was therefore submitted to a multi-detector contrast-enhanced computed tomography(CT).CT findings were initially thought to be consistent with the presumed diagnosis of internal hernia but further evaluation and coronal reformatting clearly depicted the presence of a colonic volvulus possibly resulting from a retro-gastric colon.At surgery,a volvulus of the ascending colon was found and a right hemi-colectomy had to be performed.However,a non rotated midgut with a right-sided duodeno-jejunal flexure and a left sided colon was also found at laparotomy and over-looked in the pre-operative CT.Retrospective evaluation of CT images was therefore performed and a number of CT signs of intestinal malrotation could be identified.