253.Closed-loop obstruction, CT(闭襻性肠梗阻)

每天朗读一段医学影像学英语文章

A loop of small bowel (CL) is obstructed twice at the same point of twist (solid white arrow) producing a closed loop. No oral contrast enters the closed loop but is present in a more proximal loop of small bowel (dotted white arrow). Closed-loop obstructions are important because of their higher incidence of necrosis from strangulation of the bowel.

【Closed-loop obstruction, CT 】闭襻性肠梗阻
肠管有两处梗阻，导致两梗阻点中间形成闭襻。无造影剂进入，但在近段小肠中可见。闭襻性肠梗阻要引起重视，因为绞窄处发生肠坏死几率较高。

Notes

strangulation   /ˌstræŋɡju'leiʃən/ n. 绞窄

Extensive Reading

Mechanical Obstruction: Small Bowel Obstruction (SBO)

Pathophysiology

· A lesion, either inside or outside of the small bowel, obstructs the lumen.

· Over time, from the point of obstruction backward, the small bowel dilates from continuously swallowed air and from intestinal fluid which continues to be produced by the stomach, pancreas, biliary system, and small bowel.

· Peristalsis continues and may increase in an effort to overcome the obstruction.

· This can lead to high-pitched, hyperactive bowel sounds.

· As time passes, the peristaltic waves empty the small bowel along with the colon of their contents from the point of obstruction forward.

· If the obstruction is complete and if enough time has elapsed since the onset of symptoms, there is usually no air found in the rectum or sigmoid.

机械性肠梗阻：小肠梗阻(SBO)

病理生理学。

存在一种小肠内部或外部的病变阻塞肠腔。

随着时间推移，由于连续吞下的气体和持续由胃、胰腺、胆道系统和小肠产生的肠液充满肠腔，小肠肠腔将从梗阻点向近端肠道逆行性逐渐扩张。

为了克服梗阻，肠道将持续蠕动或增加。这可导致高亢、活跃的肠鸣音。

随着时间推移，蠕动波将推动梗阻远端的小肠和结肠内容物向前移动。

如果是完全性肠梗阻，在出现症状足够长时间后，直肠或乙状结肠内通常见不到气体影。

来源：每天朗读一段医学影像学英语文章

圈主

深圳市人民医院放射科副主任医师杨敏洁

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