Difference of Ultrasonogram between Strangulation and Simple Intestinal Obstruction

Kouki Ido, Kyotaro Toshimitsu, Keichi Kimura, Kei Honda, Takashi Suzuki

Department of Surgery, Nagoya Tokushukai General Hospital

The benefits of ultrasound in the diagnosis of strangulation obstruction were investigated in 78 patients with adhesive intestinal obstruction (simple: strangulation=70:8). Although small bowel dilatation exceeding 3 cm in diameter, ascites, and a dilated bowel loop containing sediments of debris are three features specific to strangulation obstruction, ultrasonographic properties of ascites and intestinal wall changes are not. We classified patients with adhesive intestinal obstruction into 3 grades based on three ultrasonographic aspects; grade 1 included zero to one of these features (simple: strangulation=48:0), grade 2 included with two features (simple: strangulation=27:1), and those with grade 3 included all three (simple: strangulation=1:7). Therapeutic strategies were determined according to each grade; patients with grade 1 should be treated for simple intestinal obstruction, those with grade 2 require close observation because of the possibility of strangulation, those with grade 3 must be operated upon for strangulation. This classification using ultrasound is very useful for the treatment of patients with intestinal obstruction.

Key words
ultrasonic diagnosis, strangulation obstruction, simple intestinal obstruction

Reprint requests
Kouki Ido Department of Surgery, Nagoya Tokushukai General Hospital JAPAN

Accepted
September 11, 1996

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