[Pneumo-peritoneum helico-CT imaging in post-operative peritoneal adhesion].
OBJECTIVE
To discuss the diagnostic value of pneumoperitoneum helico-CT imaging (PHCT) in cases of post-operative peritoneal adhesion (POPA).


METHODS
We retrospectively analyzed the PHCT scan pictures from 32 consecutive patients with chronic abdominal pain or recurrent mechanical intestinal obstruction after abdominal operation.


RESULTS
In a normal peritoneal cavity without adhesion, an air distended dome-like space would be demonstrated with the abdominal organs arranged smoothly on the bottom of the shadow. Any additional shadow appearing in the dome-space would suggest adhesion or something abnormal. Positive findings of peritoneal adhesion were found in 30 of the 32 patients (93.75%). A spot adhesion at the abdominal wall making a kinking of intestine usually showed a cuneiform bulging shadow pointed to the roof of the dome-space. Organs involved in the adhesion may be single or multiple, including the liver, stomach, small intestine, colon, uterus, and omentum. In all the 32 patients, PHCT diagnosis was confirmed by the subsequent laparoscopy treatment.


CONCLUSIONS
PHCT imaging is valuable in making a definite diagnosis of POPA, particularly before a blind laparoscopic exploration. It is a replacement for laparoscopy but much simpler, and may offer a valuable help in dealing with the difficult cases of suspected POPA. A negative imaging is sometimes very important to an undetermined postoperative chronic abdominal pain.
Cai
Xiaojun
X
Department of General Surgery, General Hospital of Chinese People's Armed Police Forces, Beijing 100039, China. wjcaixiaojun@126.com
Han
Chengxin
C
Ye
Daobin
D
Jia
Yuanli
Y
Tang
Hongwei
H
Wang
Wei'an
W
Duan
Liang
L
D000005:Abdomen / Q000601:surgery; D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010532:Peritoneal Diseases / Q000000981:diagnostic imaging*; D011028:Pneumoperitoneum, Artificial; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D000267:Tissue Adhesions / Q000000981:diagnostic imaging; D036542:Tomography, Spiral Computed / Q000379:methods*; D055815:Young Adult