İnce bağırsak obstrüksiyonlu hastaların tanısında bilgisayarlı tomografi bulgularının rolü

Yıl 2018, , 85 - 90, 02.07.2018

İsmail Şerifoğlu , İbrahim İlker Öz , Alptekin Tosun Mustafa Kemal Demir

https://doi.org/10.30565/medalanya.388620

Öz

Amaç: Bu prospektif araştırmanın amacı, ince barsak tıkanıklığı (İBT) değerlendirilmesinde bilgisayarlı tomografi (BT) bulgularının prognostik değerini araştırmaktır. 

Hastalar ve Yöntem: Akut karın ağrısı olan ve İBT araştırılmasında BT çekilen altmış hasta çalışmamıza dahil edildi. Bunlardan, 47 hasta (26 erkek; 21 kadın ve ortalama yaş; 60) nın sonuçları değerlendirildi. BT değerlendirme parametreleri olarak: mezenterik kirlenme, geçiş zonu, feces işareti, intramural hava ve intraperitoneal serbest sıvı kullanıldı. 

Bulgular: Mezenterik kirlenme, geçiş zonu ve intramural hava BT bulguları ile İBT tanısı arasında istatistiksel anlamlı ilişki bulundu (p<0.05). Bu BT bulguları İBT tanısında yüksek sensitivite ve pozitif prediktif değere (PPD) sahiptir. Mezenterik kirlenme, geçiş zonu ve intramural hava bulgularının kombinasyonu ile İBT tanısı arasında istatistiksel anlamlı bir ilişki saptandı (p<0.05). İnce barsak feces bulgusu ile intraperitoneal serbest sıvı bulgusunun İBT tanısı ile arasında istatistiksel anlamlı bir ilişki saptanmadı (p>0.05). Üç veya daha fazla BT bulgusunun beraber bulunması durumunda İBT tanısında istatistiksel anlamlı değeri olduğu saptandı (p<0.05). 

Sonuç: Mezenterik kirlenme ve geçiş zonu bulguları İBT tanısında en yüksek sensitivite ve PPD sahiptir. Mezenterik kirlenme, geçiş zonu ve intramural hava bulgularının kombinasyonu ile üç veya daha fazla BT bulgusunun beraber bulunması durumunda İBT tanısında spesifite belirgin oranda artmaktadır. 

Anahtar Kelimeler

computed tomography, feces sign, transition zone, mesenteric congestion, small bowel obstruction

The role of computed tomography signs in diagnosis of patients with small bowel obstruction

Öz

Aim: The goal of this prospective study is to evaluate the prognostic impact of computed tomography (CT) signs in the analysis of small bowel obstruction (SBO). 

Patients and Method: Sixty consecutive patients with acute abdominal pain who were examined using abdominal CT to diagnose SBO were included in the study. 47 patients of them (26 male; 21 female and mean age, 60 years), were evaluated. CT evaluation parameters were mesenteric congestion, transition zone, feces sign, intramural air and intraperitoneal free fluid. 

Results: There was a statistically significant association between the SBO diagnosis and CT findings for mesenteric congestion, transition zone and intramural air (p<0.05 for all). These CT signs had greatest sensitivity and positive predictive value (PPV) in diagnosis of SBO. The combination of mesenteric congestion, transition zone and in-tramural air showed a significant association in the diagnosis of SBO (p<0.05). Small bowel feces sign and intraperitoneal free fluid findings had no statistically significant value in the diagnosis of SBO (p>0.05). When three or more CT findings were seen together, there was a statistically significant association in the diagnosis (p<0.05). 

Conclusion: Mesenteric congestion and transition zone had the highest sensitivity and PPV in diagnosing SBO. The combination of mesenteric congestion, transition zone and intramural air and the presence of three or more CT signs markedly increase the specificity in diagnosis of SBO. 

Anahtar Kelimeler

computed tomography, feces sign, transition zone, mesenteric congestion, small bowel obstruction

Kaynakça

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