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Multimodality Diagnosis of Mesenteric Ischemia
Published on: July 21, 2023
[Mutiple-slice spiral CT diagnosis of atypical intraabdominal hernia]
Li-min Zhang1, Chong-quan Huang, Chen-di Teng
1Department of Radiology, Wenzhou Medical College, Wenzhou 325000, China. zlm586@126.com
Objective:
To discuss the value of multiple-slice spiral CT diagnosis of atypical intraabdominal hernia.
Methods:
The clinical and CT findings of 16 cases of atypical intraabdominal hernia confirmed surgically were retrospectively analysed.
Results:
In all the 16 cases, the contents of hernia were small bowels and the mesentery. Nine cases were caused by the adhesion after abdominal operations or infection, 6 by the mesenteric foramen, and 1 by the gap of pelvic peritoneum. The main CT findings were as follows:(1)the obstructed small bowels gathered abnormally and showed cluster shape(9 cases); the walls of the bowels thickened with edema and showed "target" sign with exudate in the neighboring spaces(5 cases); other part of the abdominal cavity became empty for lack of small bowels(4 cases).(2) Abnormal arrangement of the branches of mesenteric vessel, which appeared gathered or pulled or rigid and displacement of the main branches to left or right(12 cases). Thickened mesenteric vessel (4 cases): torsion of mesentery with "whirlpool" sign (3 cases). (3) With the help of multiplanar reformation, 5 cases showed the evidence of hernia rings. In the ring area, there were gathered or pulled or rigid and radiating mesenteric vessel and the dilated or effusion bowels in cluster arrangement forming "parachute" and "bundle of balloons" sign.
Conclusion:
CT manifestations of atypical intraabdominal hernia has some specific characteristics, which is of important value for clinical diagnosis and treatment.
Insights
Multiple-slice spiral CT effectively diagnoses atypical intraabdominal hernias by identifying characteristic bowel and mesenteric vessel changes. This imaging modality is valuable for surgical planning and treatment.
Area of Science:
- Radiology
- Abdominal Imaging
- Surgical Anatomy
Background:
- Atypical intraabdominal hernias present diagnostic challenges.
- Accurate diagnosis is crucial for effective surgical intervention.
Purpose of the Study:
- To evaluate the diagnostic utility of multiple-slice spiral CT for atypical intraabdominal hernias.
- To correlate CT findings with surgical confirmations.
Main Methods:
- Retrospective analysis of 16 surgically confirmed atypical intraabdominal hernia cases.
- Review of clinical data and multi-slice spiral CT findings.
Main Results:
- CT revealed characteristic patterns including clustered obstructed small bowels, thickened bowel walls with "target" sign, and empty abdominal cavities.
- Mesenteric vessel abnormalities such as gathered, pulled, or rigid branches, and "whirlpool" sign were observed.
- Multiplanar reformation identified hernia rings with specific mesenteric vessel and bowel arrangements, forming "parachute" and "bundle of balloons" signs.
Conclusions:
- Multiple-slice spiral CT demonstrates specific imaging characteristics for atypical intraabdominal hernias.
- These CT findings are valuable for clinical diagnosis and guiding treatment strategies.
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