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Affections du côlon en situation d’urgence et en réanimation chez le patient adulte : qu’attendre du radiologue ?

Diseases of the colon in adult patients: the role of radiologist in the emergency and critical care situations

  • Enseignement Supérieur en Réanimation
  • Médecin
  • Published:
Réanimation

Résumé

L’objectif de cet article est de donner un état des lieux des réponses actuelles du radiologue aux questions que les urgentistes et réanimateurs se posent dans leur vie quotidienne, lorsqu’une atteinte colique est suspectée chez un patient adulte. Les techniques radiologiques seront présentées, avec ce qu’elles peuvent apporter dans quelques situations cliniques usuelles telles qu’une colite infectieuse, une colite inflammatoire, une colite ischémique et les situations postopératoires intestinales, en particulier les déhiscences de suture.

Abstract

The aim of this paper is to present an overview of the usefulness of imaging techniques for the management of acute disorders of the colon in adult patients. Contributions and limitations of the imaging techniques are presented, including infection, inflammation, ischemia, and post-operative complications of the colorectal surgery.

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Références

  1. Ahn SH, Mayo-Smith WW, Murphy BL, et al (2002) Acute non traumatic abdominal pain in adult patients: abdominal radiography compared with CT evaluation. Radiology 225:159–164

    Article  PubMed  Google Scholar 

  2. Bohner H, Yang Q, Franke C, et al (1998) Simple data from history and physical examination help to exclude bowel obstruction and to avoid radiographic studies in patients with acute abdominal pain. Eur J Surg 164:777–784

    Article  PubMed  CAS  Google Scholar 

  3. Marincek B (2002) Nontraumatic abdominal emergencies: acute abdominal pain: diagnostic strategies. Eur Radiol 12:2136–2150

    PubMed  CAS  Google Scholar 

  4. Grassi R, Romano S, Pinto A, Romano L (2004) Gastro-duodenal perforations: conventional plains films, US and CT findings in 166 consecutive patients. Eur J Radiol 50:30–36

    Article  PubMed  Google Scholar 

  5. Puylaert JBCM, van der Zant FM, Rijke AM (1997) Sonography and the acute abdomen: pratical considerations. AJR 168:179–186

    Article  PubMed  CAS  Google Scholar 

  6. Puylaert JB (2003) Ultrasonography of the acute abdomen: lost art or future stethoscope? Eur Radiol 13:1203–1206

    PubMed  Google Scholar 

  7. Simeone JF, Novelline RA, Ferucci JT, et al (1985) Comparison of sonography and plain films in evaluation of the acute abdomen. AJR 144:49–52

    Article  PubMed  CAS  Google Scholar 

  8. Puylaert JB (1990) Ultrasound of appendicitis and its differential diagnosis. Springer-Verlag Berlin, Heidelberg

    Book  Google Scholar 

  9. Puylaert JB, Rutgers PH, Lalisang RI, et al (1987) A prospective study of ultrasonography in the diagnosis of appendicitis. N Engl J Med 317:666–669

    Article  PubMed  CAS  Google Scholar 

  10. Birnbaum BA, Wilson SR (2000) Appendicitis at the Millenium. Radiology 215:337–348

    PubMed  CAS  Google Scholar 

  11. Danse E (2004) Imagerie des urgences abdominales non traumatiques de l’adulte. Encyclopédie médico-chirurgicale 33-705-A-10:33

    Google Scholar 

  12. Bruel JM (2003) Acute colonic diverticulitis: CT or ultrasound. Eur Radiol 13:2557–2559

    Article  PubMed  Google Scholar 

  13. Poletti PA, Platon A, Rutschmann O, et al (2004) Acute left colonic diverticulitis: can CT findings be used to predict recurrence? AJR 182:1159–1165

    Article  PubMed  Google Scholar 

  14. Horton KM, Corl FM, Fishman EK (2000) CT evaluation of the colon: inflammatory disease. Radiographics 20:399–418

    PubMed  CAS  Google Scholar 

  15. Danse E, Van Beers BE, Clapuyt P, Taourel P (2003) Imagerie de l’appendicite: état de la question. SFR Paris octobre 2003. Formation médicale continue, pp 139–148

  16. Ongolo-Zogo P, Borson O, Garcia P, et al (1999) Acute gastroduodenal peptic ulcer perforation: contrast-enhanced and thinsection spiral CT findings in 10 patients. Abdom Imaging 24:329–332

    Article  PubMed  CAS  Google Scholar 

  17. Lee DH, Lim JH, Ko YT, Yoon Y (1990) Sonographic detection of pneumoperitoneum in patients with acute abdomen. AJR 154:107–109

    Article  PubMed  CAS  Google Scholar 

  18. Geukens D, Danse E, Vershuren F, et al (2005) Perforation sigmoïdienne traumatique: intérêt du bilan tomodensitométrique. J Radiol 86 (in press)

  19. Gayer G, Hertz M, Zissin R (2004) Post-operative pneumoperitoneum: prevalence, duration and possible significance. Semin Ultrasound CT MR 25:286–289

    Article  PubMed  CAS  Google Scholar 

  20. Zissin, R, Gayer G (2004) Postoperative anatomic and pathologic findings at CT following colonic resection. Semin Ultrasound CT MR 25:222–238

    Article  PubMed  Google Scholar 

  21. Stroman DL, Bayouth CV, Kuhn JA, et al (1999) The role of computed tomography in the diagnosis of acute appendicitis. Am J Surg 178:485–489

    Article  PubMed  CAS  Google Scholar 

  22. Bendeck SE, Nino-Murcia M, Berry GJ, Jeffrey RB (2002) Imaging for suspected appendicitis: negative appendectomy and perforation rates. Radiology 225:131–136

    Article  PubMed  Google Scholar 

  23. Naoum JJ, Mileski WJ, Daller JA, et al (2002) The use of abdominal computed tomography scan decreases the frequency of misdiagnosis in cases of suspected appendicitis. Am J Surg 184:587–589

    Article  PubMed  Google Scholar 

  24. Rao PM, Rhea JT, Novelline RA, et al (1998) Effect of computed tomography of the appendix on treatment of patients and use of hospital resources. N Engl J Med 338:141–146

    Article  PubMed  CAS  Google Scholar 

  25. Storm-Dickerson TL, Horattas MC (2003) What have we learned over the past 20 years about appendicitis in the elderly? Am J Surg 185:198–201

    Article  PubMed  Google Scholar 

  26. Rao PM, Rhea JT, Rao JA, Conn AKT (1999) Plain abdominal radiography in clinicaly suspected appendicitis: diagnosis yield, resource use, and comparison with CT. Am J Emerg Med 17:325–328

    Article  PubMed  CAS  Google Scholar 

  27. Mindelzun RE, MCCort JJ (1989) Acute abdomen. In: Margulis AR, Burhenne HJ (eds) Alimentary tract radiology, 4th edition. Mosby, St-Louis Missouri

    Google Scholar 

  28. Benjaminov O, Atri M, Hamilton P, Rappaport D (2002) Frequency of visualization and thickness of normal appendix at nonenhanced helical CT. Radiology 225:400–406

    Article  PubMed  Google Scholar 

  29. Rao PM, Rhea JT, Novelline RA, et al (1997) Helical CT technique for the diagnosis of appendicitis: prospective evaluation of a focused appendix CT examination. Radiology 202:139–144

    PubMed  CAS  Google Scholar 

  30. See TC, Watson CJE, Dixon AK (2002) Appendicitis: spectrum of appearance on helical CT. Br J Radiol 75:775–781

    PubMed  CAS  Google Scholar 

  31. Rao PM, Wittenberg J, McDowell RK, et al (1997) Appendicitis: use of arrowhead sign for diagnosis at CT. Radiology 202:363–366

    PubMed  CAS  Google Scholar 

  32. van Breda Vriesman AC, Kole BJ, Puylaert JB (2003) Effect of ultrasonography and optional computed tomography on the outcome of appendectomy. Eur Radiol 13:2278–2282

    Article  PubMed  Google Scholar 

  33. Taourel P, Kessler N, Blayac PM, et al (2002) Imagerie de l’appendice: échographie, scanner ou rien du tout ? J Radiol 83:1952–1960

    PubMed  CAS  Google Scholar 

  34. Ripolles T, Agramunt M, Martinez MJ, et al (2003) The role of ultrasound in the diagnosis, management and evolutive prognosis of acute left-sided colonic diverticulitis: a review of 208 patients. Eur Radiol 13:2587–2595

    Article  PubMed  Google Scholar 

  35. Detry R, Jamez J, Kartheuser A, et al (1992) Acute localized diverticulites: optimum management requires accurate staging. Int J Colorect Dis 7:38–42

    Article  CAS  Google Scholar 

  36. Lundstedt C, Hederstrom E, Holmin T, et al (1983) Radiological diagnosis in proven intra-abdominal abscess formation: a comparison between plain films of the abdomen, ultrasonography and computerized tomography. Gastrointest Radiol 8:261–266

    Article  PubMed  CAS  Google Scholar 

  37. Pradel JA, Adell JF, Taourel P, et al (1997) Acute colonic diverticulites: prospective comparative evaluation with US and CT. Radiology 205:503–512

    PubMed  CAS  Google Scholar 

  38. Jang HJ, Lim HK, Lee SJ, et al (2000) Acute diverticulitis of the cecum and ascending colon: the value of thin-section helical CT findings in excluding colonic carcinoma. AJR 174:1397–402

    Article  PubMed  CAS  Google Scholar 

  39. Padidar AM, Jeffrey RB, Mindelzun RE, Dolph JF (1994) Differentiating sigmoid diverticulites from carcinoma on CT-scan: mesenteric inflammation suggest diverticulites. AJR 163:81–83

    Article  PubMed  CAS  Google Scholar 

  40. Feldman D (2000) The coffee bean sign. Radiology 216:178–179

    PubMed  CAS  Google Scholar 

  41. Wales L, Tysome J, Lim A, et al (2004) Image of interest: gastrointestinal: cecal volvulus. J Gastroenterol Hepatol 19:225

    Article  Google Scholar 

  42. Majeski J (2005) Operative therapy for cecal volvulus combining resection with colopexy. Am J Surg 189:211–213

    Article  PubMed  Google Scholar 

  43. Shaff MI, Himmelfarb E, Sacks GA, et al (1985) The whirl sign: a CT finding in volvulus of the large bowel. J Comput Assist Tomogr 9:410

    PubMed  CAS  Google Scholar 

  44. Catalano O (1996) Computed tomographic appearance of sigmoid volvulus. Abdom Imaging 21:314–317

    Article  PubMed  CAS  Google Scholar 

  45. Danse EM, Van Beers BE, Goncette L, et al (1996) Value of echography in the diagnosis of acute intestinal occlusion. J Radiol 77:1223–1227

    PubMed  CAS  Google Scholar 

  46. Taourel P, Garibaldi F, Arrigoni J, et al (2004) Cecal pneumatosis in patients with obstructive colon cancer: correlation of CT findings with bowel viability. AJR 183:1667–1671

    Article  PubMed  Google Scholar 

  47. Taourel P, Guillon F, Aufort S, et al (2003) Imagerie des occlusions: les questions du chirurgien, les réponses de l’imageur. JFR, Formation médicale continue 61:725–737

    Google Scholar 

  48. Heffernan C, Pachter HL, Megibow AL, Macari M (2005) Stercoral colitis leading to fatal peritonitis: CT findings. AJR Am J Roentgenol 184:1189–1193

    Article  PubMed  Google Scholar 

  49. Danse EM, Jamart J, Hoang P, et al (2004) Focal bowel wall changes detected with colour Doppler ultrasound: diagnostic value in acute non-diverticular diseases of the colon. Br J Radiol 77:917–921

    Article  PubMed  CAS  Google Scholar 

  50. Truong M, Atri M, Bret PM, et al (1998) Sonographic appearances of benign and malignant conditions of the colon. AJR Am J Roentgenol 170:1451–1455

    Article  PubMed  CAS  Google Scholar 

  51. Pradel JA, David XR, Taourel P, et al (1997) Sonographic assessment of the normal and abnormal bowel wall in nondiverticular ileitis and colitis. Abdom Imaging 22:167–172

    Article  PubMed  CAS  Google Scholar 

  52. Triadafilopoulos G, Hallstone AE (1991) Acute abdomen as the first presentation of pseudomembranous colitis. Gastroenterology 101:685–691

    PubMed  CAS  Google Scholar 

  53. Philpotts LE, Heiken JP, Westcott MA, Gore RM (1994) Colitis: use of CT findings in differential diagnosis. Radiology 190:445–449

    PubMed  CAS  Google Scholar 

  54. Kirckpatrick IDC, Greenberg HM (2003) Gastrointestinal complications in the neutropenic patient: characterization and differentiation with abdominal CT. Radiology 226:668–674

    Article  Google Scholar 

  55. Kalantari BN, Mortelé KJ, Cantisani V, et al (2003) CT features with pathologic correlation of acute gastrointestinal Graft-Versus-Host disease after bone marrow transplantation in Adults. AJR 181:1621–1625

    Article  PubMed  Google Scholar 

  56. Cantisani V, Mortele KJ, Visconi SG, et al (2003) Rectal inflammation as first manifestation of graft-vs-host disease: radiologicpathologic findings. Eur Radiol 13:L75–L78

    Article  Google Scholar 

  57. Sturm EJ, Cobben LP, Meijssen MA, et al (2004) Detection of ileocecal Crohn’s disease using ultrasound as the primary imaging modality. Eur Radiol 14:778–782

    Article  PubMed  CAS  Google Scholar 

  58. Tarjan Z, Toth G, Gyorke T, et al (2000) Ultrasound in Crohn’s disease of the small bowel. Eur J Radiol 35:176–182

    Article  PubMed  CAS  Google Scholar 

  59. Balthazar EJ, Yen BC, Gordon RB (1999) Ischemic colitis: CT evaluation of 54 cases. Radiology 211:381–388

    PubMed  CAS  Google Scholar 

  60. Danse EM, Van Beers BE, Jamart J, et al (2000) Prognosis of ischemic colitis: comparison of color Doppler sonography with early clinical and laboratory findings. AJR 175:1151–1154

    Article  PubMed  CAS  Google Scholar 

  61. Ripolles T, Simo L, Martinez-Perez MJ, et al (2005) Sonographic findings in ischemic colitis in 58 patients. AJR Am J Roentgenol 184:777–785

    Article  PubMed  Google Scholar 

  62. Philpotts LE, Heiken JP, Westcott MA, Gore RM (1994) Colitis: use of CT findings in differential diagnosis. Radiology 190:445–449

    PubMed  CAS  Google Scholar 

  63. Gore RM, Berlin JW, Yaghmai V, et al (2004) CT diagnosis of post-operative abdominal complications. Semin Ultrasound CT MR 25:207–221

    Article  PubMed  Google Scholar 

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Correspondence to E. Danse.

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Cet article correspond à la conférence faite par l’auteur au congrès de la SRLF 2012 dans la session: Colites graves.

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Danse, E., Dragean, A. Affections du côlon en situation d’urgence et en réanimation chez le patient adulte : qu’attendre du radiologue ?. Réanimation 21 (Suppl 2), 363–372 (2012). https://doi.org/10.1007/s13546-011-0340-1

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  • DOI: https://doi.org/10.1007/s13546-011-0340-1

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