自发的勒死的 transomental 脱肠: 未来、回顾的多察觉者计算了断层摄影术调查结果

• 作者: Angela De Gennaro Emanuela Calabrese Giovanni Persico Luigi Camera Marco Salvatore Margaret Longobardi 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: Small bowel OBSTRUCTION Internal HERNIAS Transomental HERNIA Multi-detector row computed tomography STRANGULATION
• 年，卷（期）: 2014,（2）
• 页码范围: 26-30
• 页数: 5页
• 分类号: R656.2

摘要

Transomental hernias are among the rarest type of all internal hernias which overall account for less than 6% of small bowel obstructions. Most transomental hernias occurring in adults are either iatrogenic or post-traumatic. More rarely, a spontaneous herniation of small bowel loops may result from senile atrophy of the omentum. We report a case of an 86-year-old male who presented with signs and symptoms of small bowel obstruction but had no past surgical or traumatic abdominal history. At contrast-enhanced multi-detector row computed tomography(CT), a cluster of fluid-filled dilated small bowel loops could be appreciated in the left flank, with associated signs of bowel wall ischemia. Swirling of the mesenteric vessels could also be appreciated and CT findings were prospectively considered consistent with a strangulated small bowel volvulus. At laparotomy, no derotation had to be performed but up to 100 cm of gangrenous small bowel loops had to be resected because of a transomental hernia through a small defect in the left part of the greater omentum. Retrospective reading of CT images was performed and findings suggestive of transomental herniation could then be appreciated.