Abdurrahim DUSAK, Bircan ALAN, Abdulmenap GÜZEL, Muharrem ÇAKMAK, Fatih TAŞKESEN, Cemil GÖYA, Aslan BİLİCİ

Akut batında multiplanar reformat BT enterografi

Amaç: Akut batın ile başvuran, mekanik ileus tanısı alan olgularda, cerrahi - histopatoloji verileri ile BT Enterografi BTE bulgularının korelasyonu araştırıldı. Gerek ve Yöntem: Merkezimiz Acil servisine akut batın ile başvuran ve Genel Cerrahi servisinde mekanik ileus tanısı ile opere edilen ardışık 91 olgu 46 kadın, 45 erkek; yaş: 44±11 çalışmaya alındı. Çok kesitli BT 64 dedektör BT, Philips Brillance ile BTE; ksifoid proçesten ve simfizis pubise kadar, nefes tutturularak tarandı. Radyolojik bulgular; cerrahi ve histopatolojik veriler ile korele edildi. Bulgular: Akut batın ile başvuran ve mekanik ileus tanısı alan olguların %82'inde GIT obstrüksiyonu saptandı. Etyopatolojide BTE'nin sensitivitesi %85 spesifitesi %55 olup olgularda %80 ince barsak, %20 kalın barsak obstrüksiyonu brid ileus, kitle, herni, mezenter iskemi, perforasyon, peritonitis karsinomatoza, volvulus, invajinasyon, anastomoz darlığı, torsiyon, anastomoz darlığı, abse, gossipiboma, safra taşı ileusu ve malrotasyon saptandı. GIT obstrüksiyonu ile mezenterik kirlenme, batın içi serbest sıvı, inci dizisi bulgusu ve geçiş zonu arasında istatistiksel olarak anlamlı korelasyon saptandı. Ancak duvar kalınlaşması, kitle, feçes sign, peritoneal nodül, whirl sign, target sign, batın içi serbest hava ve pneumatosis intestinalis ile anlamlı korelasyon saptanmadı. Sonuç: Akut batın ile başvuran olgularda, GIT obstrüksiyonu varlığı ve etyopatolojisinin belirlenmesinde; BTE etkin, tanı değeri yüksek bir Radyolojik görüntüleme yöntemidir.

Anahtar Kelimeler:

BT Enterografi, akut batın, mekanik ileus, brid

Multiplanar reformatted CT enterography in acute abdomen

Aim: To investigate the correlation between surgical - histopathological data and CT enterography CTE in patients with acute abdomen due to mecanical ileus. Methods: Ninety one 46 female, 45 male; 44±11 year- old consecutive acute abdomen cases admitted to emergency department and operated in general surgery department with a preoperative diagnoses of mechanical ileus were included in this study. CTE was carried-out using Multi sliced CT 64 detector CT, Philips Brilliance . Subjects were scanned from xiphoid process to symphysis pubis during a single breath-hold. Correlation analyses were done between radiological findings and surgical and histopathological findings. Result: Gastrointestinal tract GIT obstruction finding was evident in 82% of subjects with mecanical ileus and acute abdomen. Sensitivity and specificity of CTE was 85% and 55% respectively in terms of demonstration of etiopathology. 80% of cases had small bowel obstruction and remaining 20% had large bowel obstruction. Bridled ileus, mass, hernia, mesenteric ischemia, perforation, peritonitis carcinomatosa, volvulus, invagination, narrowed anastomosis, torsion, abscess, gossypiboma, gallstone ileus and malrotation were among underlying etiological factors. Statistically significant correlation found between GIT obstruction and findings such as mesenteric stranding, intra abdominal free fluid, string of pearls sign and transition-zone. In contrary, bowel wall thickening, mass lesion, faeces sign, peritoneal nodule, whirl sign, target sign, intra abdominal free air, pneumatosis intestinalis were not statistically significantly correlated with GIT obstruction. Conclusion: CT Entherography is an efficient imaging modality with high diagnostic value in demonstrating the existence and etiopathology of bowel obstruction.

Keywords:

CT enterography, mechanic ileus, acute abdomen, bridle,

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Yayın Aralığı: Yılda 3 Sayı
Başlangıç: 2009
Yayıncı: Maltepe Üniversitesi

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