临床病史：男性，30岁，急性上腹痛就诊，便秘并呕吐多次，车祸后脾脏撕裂行脾切除术后病史。行DR及CT检查。
Presentation:Male,30ys,presented with acute abdominal pain,constipation and vomitting,history of splenic trauma by splenectomy following a road accident.As a part of diagnostic work,DR and CT are ordered.
DR可见小肠区弥漫性扩张并见低密度影填充，集中在中下腹。
Diffuse dilation of small bowel loops is present with low attenuation on DR，which situated at middle-lower abdomen.
CT可见弥漫性扩张小肠肠管位于回肠区中部，其内积液填充，可见狭窄点。冠状位可见旋涡征，非常典型，提示肠扭转，高度可疑黏连所致。
CT shows diffuse dilated small intestinal loops with fliud down in the mid-ileal region.There is a clear transition point.
Coronal CT shows characteristic swirling sign,indicating small bowel volvulus,most likely caused by adhesion.
肠扭转Volvulus
肠扭转是腹腔肠道危重症，大小肠均可发生，乙状结肠更为常见。主要是由于发生于肠系膜旋转的机械性梗阻。
Volvulus is a critical disease resulting in mechanical obstruction twisted by mesentery,which occurs in either small intestine or large intestine, most common in sigmoid colon.
肠扭转多继发肠梗阻，肠管弥漫性扩张并液气平面形成，管壁积气，肠管坏死均可发生。
The common complication associated with volvulus is bowel obstruction,which demonstrates diffuse dilation of bowel loops with air-fluid level,intestinal pneumatosis,even necrotic bowel wall.
DR可见肠梗阻征象，多发液气平面形成如阶梯征，乙状结肠重度扩张形如咖啡豆征。
Bowel obstruction on DR demonstrates step-ladder sign with multiple air-fluid levels,coffee bean sign with significant dilated sigmoid colon.
CT显示更多细节，结合MPR重建，如梗阻点的肠系膜的旋涡征，肠管的扩张程度，管壁是否积气，管壁的炎性水肿，注意如果管壁重度坏死会呈现和正常肠管一样的菲薄改变，需要警惕。
MPR of CT shows more details about swirling sign at the transition point of twisted mesentery,bowel wall pneumatosis and edema.Note severe necrotic bowel wall reveals as thin as the normal bowel wall.
肠扭转及肠梗阻并发症需要及时手术治疗。
Volvulus with complications need surgery.
本文到此结束。
The End
