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The Value of Different Patterns of Small Bowel Dilatation in Diagnosing Ileus on Supine Abdominal Radiograph
單純腹部背臥位攝影對診斷動態性及非動態性腸閉塞結果比較
摘要
本文探討單純腹部背臥位攝影，在診斷動態性腸閉塞之結果比較的回溯性研究。在台東馬偕分院由1990年至1992年有96個腸閉塞病例。我們把急性腹痛病人的擴張腸環結單純腹部背臥位X光片分成四組作進一步分析。第一組的病人只有一個超過3公分的膨脹環結；第二組病人有二或多個多處不同分佈的膨脹腸環結：第三組的病人腸環結成梯狀或鄰近腸環結緊黏在一起；第四組病人不單有小腸擴張，大腸也有膨脹。在比較後，最常見的非動態性腸閉塞X光徵像有拱衛環結徵象(89%)，麻痺性徵象(87%)及多發性，多處性腸擴張環結(81%)；另一方面，最常見的機械性閉塞X光徵象是腸環結成梯狀(81%)。
並列摘要
A retrospective study was performed to determine the value of supine abdominal radiograph in differentiating between dynamic and adynamic ileus. Supine films from 96 cases of ileus in our hospital were reviewed. These patients were divided into four groups depending on the patterns of ileus that appeared on supine abdominal radiographs taken during the acute presentation of illness. Group 1 patients were those whose supine films showed only a single distended small bowel loop with a caliber greater than 3 cm. Group 2 patients were those whose films showed two or more distended but scattered small bowel loops. Group 3 patients were those whose films showed two or more distended but scattered small bowel loops abutting each other or in a stepladder pattern. Group 4 patients were those whose films showed a picture considered to be paralytic ileus with small and large bowel dilatation. The most reliable signs of adynamic (functional) ileus were the patterns in Group 1, 2, and 4, with diagnostic specificities of 89%, 81% and 87% respectively. The specificity of the pattern seen in Group 3 in diagnosing dynamic ileus was 81%. Proper interpretation of the radiographic patterns of ileus and knowledge of the limitations of radiography in this condition should lead to a more accurate diagnosis of ileus.