Motta-Ramírez GA, Alonso-Blancas É, González-Merino LI, Montero MJC

Language: Spanish
References: 15
Page: 157-164
PDF size: 224.15 Kb.

ABSTRACT

Introduction. The indications for multidetector computed tomography include evaluation of intestinal obstruction syndrome, and although internal hernia represents less than 1% of cases of abdominal hernias, it is a conditioning factor in 5.8% of intestinal obstruction syndromes.
Objectives. Recognize multidetector computed tomography in initial or subsequent evaluation of intestinal obstruction syndrome with emphasis on identification of signs that help in preoperative recognition of internal hernias, including those that are not concurrent with intestinal obstruction syndrome.
Material and methods. From August 2005 to June 2011 patients were included who, based on indication and clinical diagnosis of intestinal obstruction syndrome, underwent multidetector computed tomography using an intra-institutional protocol, with reconstructions in 3D, multiplanar reconstructions and maximum intensity projection to recognize findings with identification of internal hernia.
Results. The universe of patients included 31 patients (13 male [42%], 18 female [58%] with ages ranging from 9 to 84 years [average 62 years]). Based on surgical antecedents and identification of internal hernia by surgery, it was shown that 6 patients (19%) presented internal hernias of the acquired type (1 pericecal, 2 transmesenteric, 2 paraduodenal and 1 of the Peterson space) and in 6 patients (19%) the internal hernia was constitutional (3 transmesenteric, 2 paraduodenal and 1 paravesical). The internal hernia most commonly suspected and identified was paraduodenal hernia in 15 patients (48%), which was surgically corroborated in 4 patients (27%).
Conclusions: Multidetector computed tomography is indicated for monitoring and identification of intestinal obstruction syndrome, emphasizing that it helps in preoperative recognition of internal hernias, in addition to the site, type, and review of the vascular status of loops, their contents, and detection of complications.

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