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Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images

Internal hernia (IH)-related surgical acute abdomen is not well understood because of the rarity of cases and underdiagnosis. This study was performed to further understand the clinicopathological features and multi-detector computed tomography (MDCT) findings of IH in cases confirmed by surgery. In...

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Autores principales: Dou, Lei, Yang, Huiyuan, Wang, Chao, Tang, Hao, Li, Dongjian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6731239/
https://www.ncbi.nlm.nih.gov/pubmed/31492915
http://dx.doi.org/10.1038/s41598-019-48241-x
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author Dou, Lei
Yang, Huiyuan
Wang, Chao
Tang, Hao
Li, Dongjian
author_facet Dou, Lei
Yang, Huiyuan
Wang, Chao
Tang, Hao
Li, Dongjian
author_sort Dou, Lei
collection PubMed
description Internal hernia (IH)-related surgical acute abdomen is not well understood because of the rarity of cases and underdiagnosis. This study was performed to further understand the clinicopathological features and multi-detector computed tomography (MDCT) findings of IH in cases confirmed by surgery. In all, 51 patients with a definite diagnosis of IH confirmed during surgical exploration from Feb. 2012 to Feb. 2018 in our hospital were included in this research. Medical records, including MDCT images and intra-operative findings, were collected retrospectively. In all, 39 and 12 cases were categorized as adhesive IH (76.5%) and non-adhesive IH (23.5%), respectively. Among the patients with adhesive IH, 73% had a history of abdominal or pelvic surgery. Additionally, the mesentery was the most common component of adhesive bands (64.1%). Congenital peritoneal abnormalities and gastrointestinal reconstruction were the main causes of non-adhesive IH.As a specific sign, the fat notch sign was much more common in adhesive IH than in non-adhesive IH (P = 0.023). Bowel wall thickening (P = 0.041), abnormal bowel wall enhancement (P = 0.006) and twisted bowels with the vessel swirl sign (P = 0.004) were indicators of bowel necrosis. Among all of the cases of IH, 34 (66.7%) were complicated by bowel necrosis, and 1 patient died. In conclusion, non-adhesive IH has different clinicopathological features and MDCT findings from those of adhesive IH. MDCT is a useful tool with high sensitivity for confirming IH and may help to guide the early treatment of IH.
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spelling pubmed-67312392019-09-18 Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images Dou, Lei Yang, Huiyuan Wang, Chao Tang, Hao Li, Dongjian Sci Rep Article Internal hernia (IH)-related surgical acute abdomen is not well understood because of the rarity of cases and underdiagnosis. This study was performed to further understand the clinicopathological features and multi-detector computed tomography (MDCT) findings of IH in cases confirmed by surgery. In all, 51 patients with a definite diagnosis of IH confirmed during surgical exploration from Feb. 2012 to Feb. 2018 in our hospital were included in this research. Medical records, including MDCT images and intra-operative findings, were collected retrospectively. In all, 39 and 12 cases were categorized as adhesive IH (76.5%) and non-adhesive IH (23.5%), respectively. Among the patients with adhesive IH, 73% had a history of abdominal or pelvic surgery. Additionally, the mesentery was the most common component of adhesive bands (64.1%). Congenital peritoneal abnormalities and gastrointestinal reconstruction were the main causes of non-adhesive IH.As a specific sign, the fat notch sign was much more common in adhesive IH than in non-adhesive IH (P = 0.023). Bowel wall thickening (P = 0.041), abnormal bowel wall enhancement (P = 0.006) and twisted bowels with the vessel swirl sign (P = 0.004) were indicators of bowel necrosis. Among all of the cases of IH, 34 (66.7%) were complicated by bowel necrosis, and 1 patient died. In conclusion, non-adhesive IH has different clinicopathological features and MDCT findings from those of adhesive IH. MDCT is a useful tool with high sensitivity for confirming IH and may help to guide the early treatment of IH. Nature Publishing Group UK 2019-09-06 /pmc/articles/PMC6731239/ /pubmed/31492915 http://dx.doi.org/10.1038/s41598-019-48241-x Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Dou, Lei
Yang, Huiyuan
Wang, Chao
Tang, Hao
Li, Dongjian
Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images
title Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images
title_full Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images
title_fullStr Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images
title_full_unstemmed Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images
title_short Adhesive and non-adhesive internal hernia: clinical relevance and multi-detector CT images
title_sort adhesive and non-adhesive internal hernia: clinical relevance and multi-detector ct images
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6731239/
https://www.ncbi.nlm.nih.gov/pubmed/31492915
http://dx.doi.org/10.1038/s41598-019-48241-x
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