Tomodensitometric Aspects of Acute Intestinal Ischemia: A Prospective Study of 20 Cases

• 作者: Adjirata Koama Bénilde Marie Ange Tiemtore-Kambou Habiba Mizouni Lobna Ben Temellist Massara Koné Sigué Nina Astrid N’de-Ouédraogo Ousséni Diallo Rabiou Cissé Yomboe Abel Bamouni
• 来源期刊: 放射学期刊(英文)
• 学科: 医学
• 关键词: Acute INTESTINAL ISCHEMIA MESENTERIC INFARCTION Angioscan ABDOMINAL PAIN
• 年，卷（期）: fsxqkyw_2019,（1）
• 页码范围: 48-57
• 页数: 10页
• 分类号: R5

摘要

Background: Acute intestinal ischemia is an abdominal suffering occasioned by a sudden reduction of mesenteric blood circulation. It is a rare and potentially serious medical-surgical emergency, deadly in 50% to 100% of cases. Diagnosis is known to be difficult at the early stage during which a well-conducted treatment may help reduce mortality. Multi-detector scanners were assessed to be far more sensitive and appropriate for the diagnosis of mesenteric ischemia than angiography. Objective: Study the tomodensitometric aspects of acute intestinal ischemia, and the traps of late diagnosis, in order to optimize the care and improve the prognosis of this disease. Patients and Methods: This is a prospective, longitudinal and descriptive study covering a period of nine (9) months. We have included all cases of acute intestinal ischemia. Results: Twenty (20) cases of acute intestinal ischemia were registered i.e. a frequency of 2.2 cases per month. The average age of the patients was 67.8 years with 0.7 as sex ratio. Abdominal pain was noted in all cases. History of cardiovascular disease was found in seven (7) cases. Abdominal angioscan was performed in fifteen (15) cases. There was a suspected diagnosis upon request in ten (10) cases. The main intestinal lesions were the lack of parietal enhancement (13 cases) and parietal thickening (12 cases). There were sixteen (16) cases of acute mesenteric ischemia and four (4) cases of ischemic colitis. The acute mesenteric ischemia was arterial in eleven (11) cases, venous in two (2) cases and mixed in two (2) cases. Diagnosis was made at the stage of intestinal infarction in eleven (11) cases. Ten (10) patients were operated and 10 others were treated medically. Thirteen (13) cases of death were registered. Conclusion: Acute intestinal ischemia is a rare but serious disease. Abdominal pain is the main ground for consultation. Diagnosis is often late and focuses on abdominal CT angiography. An early diagnosis could help improve its prognosis.