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Objective To explore the necessities and clinical value of acute intestinal obstruction with com-puted tomography of whole abdomen in over 80 years old patients.Methods 50 patients with acute intestinal obstruc-tion were diagnosed in department of emergency surgery and underwent the abdominal CT examinations.The clinical data,CT and surgery pathology of all patients were compared and analyzed.Results All cases were verified by surgi-cal operation and pathological diagnosis,including colorectal cancer(n =21)and incarcerated abdominal external her-nia(n =21),appendicitis(n =2),adhesive intestinal obstruction(n =2),intestinal volvulus (n =2),and intestinal intussusception(n =1)and stercoral intestinal obstruction(n =1),12 cases were accompanied by bowel necrosis and perforation.12 patients were treated by laparoscope surgery,38 cases by open laparotomy,48 patients acquired good recovery,and 2 cases died from extensive bowel necrosis and multi -organ failure.Conclusion CT examination in whole abdomen could rapidly and accurately diagnose the cause of intestinal obstruction,evaluate complications and risks,so as to provide reasonable treatment choice and time,making patients acquired the effective effects as soon as possible,reducing the bad consequences.
RESUMEN
Objective To analyze and summarize the efficacy and the experience in the application of type Ⅰ and type Ⅱ bundled pancreaticojejunostomy in pancreaticoduodenectomy. Methods Between Jan.2005 and Dec. 2009, a total of 38 patients who underwent bundled pancreaticojejunostomy was enrolled, and their clinical data were retrospectively analyzed. 20 patients received type Ⅰ bundled pancreaticojejunostomy and 18 patients received type Ⅱ bundled pancreaticojejunostomy. The operative time, postoperative hospital stay, mortality and complications were compared. Results The operative time of type Ⅰ bundled pancreaticojejunostomy was (91 ± 20) min, and it was (63 ± 21) min in type Ⅱ procedure, and the difference was statistically significant (P ＜ 0. 05). The mortality and complications, postoperative hospital stay were 10.0%(2/20), 45.0% (9/20) and (20 ±2)d in type Ⅰ procedure, while they were 5.6% (1/18),38.9% (7/18) and(23 ±2)d in type Ⅱ procedure, and the difference was not statistically significant.Conclusions There was no significant difference in the effects between type Ⅰ and type Ⅱ bundled pancreaticojejunostomy. Carefully selective application of type Ⅰ and type Ⅱ bundled pancreaticojejunostomy helps complete these procedures.