Vai trò của X-quang cắt lớp vi tính trong chẩn đoán lồng ruột ở người lớn

Role of abdominal computed tomography in diagnosis of adult intussception

SUMMARY

Objective: To describe imaging characteristics of adult intussception (AI) on CT and to identify diagnostic values of them.

Materials and methods: Case series report including patients: defined AI on CT, over 18 years of age, having been on surgery, with/ without histo-pathology. Patients are divided into two groups: those with enteroenteric intussusception (EI) and those with intussusceptions involving colon (IC), including enterocolic and colocolic lesions.

Results: from 01/2014 to 01/2017 at University Medical Center, HCMC, there were 53 intussusceptions of 52 patients on CT (EI: 14_26%, IC: 39_74%). 33 of those have intussusception on surgery (EI: 10_3%, IC: 23_70%). Mean length of intussusceptions of both groups is 7,6±4,0cm (2,4-19,6). Mean diameter of intussusceptions is 4,7±1,1cm (2,2-7). Mean interposed fat thickness is 1±0,6cm (0,1-2,6). CT and surgery characteristics of patients in EI group are of minor differences. Ratio of AI on CT with obstruction and with ischemia_necrosis are both 3,8%. Outcome of diagnosing complications by CT and by surgery are comparable. Characteristics capable of predicting presence of insstususception on surgery are: in EI group: lead point, length > 6cm, interposed fat thickness > 0,5 cm; in IC group: length > 5.65 cm, interposed fat thickness > 0,75 cm.

Conclusion: Characteristics capable of predicting presence of insstususception on surgery are: lead point, length, interposed fat thickness.

Key words: Computerized Tomography (CT), Intussusception, obstruction, enteric ischemia, lead point.