過去無腹腔手術或發炎病史之沾粘性腸阻塞：病例報告

Adhesion Ileus with No History of Transabdominal Surgery or Intra-abdominal Infection: A Case Report

沾粘性腸阻塞是最常見的腸阻塞類型，其中95%以上與之前經腹手術或腹腔內感染引起的腹膜損傷相關。除了臨床上理學檢查和病史，想要正確的診斷沾粘性腸阻塞，影像檢查扮演了重要角色。然而，在傳統影像上，由於沾粘的纖維組織通常是不可見的，我們只能通過排除其他造成腸阻塞的原因來進行診斷。我們報告的病例是一位79歲的男性，過去沒有經腹手術或腹腔內感染的病史，最後經手術病理驗證沾粘性腸阻塞的診斷。我們從文獻回顧了X光攝影、超音波檢查、鋇劑灌腸攝影、電腦斷層、磁振造影、電腦斷層小腸造影和磁振小腸造影等檢查在診斷沾粘性腸阻塞的應用。

Adhesions are fibrous bands, over 95% of which is the result of peritoneal injury caused by transabdominal surgery or intra-abdominal infection. Although adhesions are typically not visible using conventional imaging techniques, an adhesion can be diagnosed by exclusion based on an abrupt change in bowel caliber in the absence of evidence of another type of obstruction. The correct diagnosis and assessment of adhesions is important in determining the optimal therapeutic approach. We report surgically-verified adhesion formation in a 79-year-old male with no history of transabdominal surgery or intra-abdominal infection. The applications of plain film radiography, ultrasonography, enteroclysis, computed-tomography (CT), magnetic-resonance (MR), CT enteroclysis, and MR enteroclysis imaging techniques to the diagnosis of intra-abdominal adhesions are reviewed from the literature.