CT value of the intestine is useful predictor for differentiate irreversible ischaemic changes in strangulated ileus
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To determine the differential points of strangulated ileus with and without irreversible ischaemic changes, especially on preoperative computed tomography (CT) images.
Seventy patients with strangulated ileus underwent emergency operations between January 2009 and July 2016 in our department. Of these patients, 57 met the study requirements, including 30 patients who had irreversible ischaemic changes (ischaemic group; n = 30) and 27 patients who had reversible ischaemic changes during laparotomy (non-ischaemic group; n = 27). We compared the preoperative clinical and radiographic factors between the ischaemic and non-ischaemic groups.
Univariate analysis revealed that a mean CT value of the intestine in an unenhanced image ≥16.5 HU (p < 0.001), a mean CT value ratio of the intestine (enhanced/unenhanced image) <1.5 (p < 0.001), presence of mesenteric fluid (p = 0.002) and presence of free peritoneal fluid (p = 0.009) were associated with the ischaemic group.
Calculation of the mean CT value of a strangulated intestine may be a useful method for predicting irreversible ischaemic changes in addition to the presence of mesenteric fluid or free peritoneal fluid.
KeywordsStrangulated intestine CT value Bowel wall enhancement Ischaemic change
Compliance with ethical standards
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Conflict of interest
The authors declare that they have no conflict of interest. The authors have no direct or indirect commercial or financial incentives associated with publishing this article.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the Institutional and/or National Research Committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. For this type of study formal consent is not required. The study protocol was approved by the Institutional Review Board. The study does not include any animal experiments.
This article does not contain any studies with human participants or animals performed by any of the authors.