[Emergencies in colorectal surgery: diagnostic imaging].
In this paper we discuss the actual role of imaging in surgical management of urgency in colon-rectal pathology. We have considered four different kinds of pathologic: obstruction; occlusion; inflammatory and infections pathology; vascular pathology: In the first group an accurate radiologic evaluation in different decubitus is necessary. In negative or doubt cases, but with clinic highly suggestive for the presence of pathology, a CT examination is mandatory. In the second group, an accurate preliminary radiologic evaluation with plain radiographs of the abdomen is also necessary. With the use of contrast agents, it is possible to assess the level and the possible cause of the occlusion; at least, in some cases, (e.g. volvulus) a CT examination can be useful. The third group is concerning about inflammatory and infectious pathology: in these cases new radiologic technologies, like US and CT, play a significant role in their detection, evaluation of extension, assessment of complications. Especially in acute diverticulitis and acute appendicitis, the diagnosis is based essentially on clinical examination; and endoscopic confirmation is not possible in most cases. In all these cases, the radiologist can give to the surgeon an accurate evaluation of the pathology, with US or CT. The last group is about vascular pathology: at the moment angiography plays a secondary role in diagnosis, the use of endoscopy being more and more frequent; nevertheless, interventional radiologic procedures are successful in a lot of cases, thanks to their accuracy, low invasiveness and low percentage of complications.
Zernich
R C
RC
Istituto di Radiologia, Università degli Studi di Trieste.
D001064:Appendicitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D003108:Colonic Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D003937:Diagnosis, Differential; D004238:Diverticulitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D004630:Emergencies; D006801:Humans; D007415:Intestinal Obstruction / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D007416:Intestinal Perforation / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D012002:Rectal Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography