Pneumo-peritoneum helico-CT imaging in post-operative peritoneal adhesion / 中南大学学报(医学版)

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.@*CONCLUSION@#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.

Treatment of refractory irritable bowel syndrome with subclinical dosage of antidepressants / 中国医学科学院学报

<p><b>OBJECTIVE</b>To investigate the effect of antidepressant on irritable bowel syndrome (IBS).</p><p><b>METHODS</b>A self-control and follow-up study on subclinical dosage of antidepressants therapy (fluoxetine 10 mg/d, paroxetine 10 mg/d or doxepin 45 mg/d) for 9-12 wks in 46 patients with refractory IBS symptoms according to Rome II criteria was performed, the clinical outcomes were evaluated by scales changes of symptom-related-anxiety, severity index of symptom, and quality of life specific of IBS, as well as general psychiatric health by SCL-90 during treatment and follow-up periods.</p><p><b>RESULTS</b>All 46 cases completed therapy and first follow-up unit (12 wks after treatment) (FFU), at the end of FFU, clinical symptoms in all patients were improved (P < 0.01). Comparison of the scores of symptom-related-anxiety, index of symptom, and quality of life specific of IBS at the end of FFU with that at basal level, indexes of the severity (3.4 +/- 1.5 vs 1.8 +/- 0.84) and frequency (3.8 +/- 1.60 vs 2.0 +/- 0.76) of symptoms were subsided significantly (P < 0.01, respectively); the scores of symptom-anxiety questionnaire including body anxiety (16.04 +/- 1.65 vs 10.83 +/- 1.64, P < 0.001), cognitive anxiety (18.78 +/- 2.12 vs 11.17 +/- 1.89, P < 0.001), fear (15.80 +/- 1.76 vs 10.78 +/- 1.85, P < 0.001) and avoiding (15.47 +/- 1.53 vs 10.16 +/- 1.59, P < 0.001) were also subsided significantly. In the meantime, IBS-QoL improved significantly (P < 0.05), dysphoria, body image, interference with activity, health worry, social reaction and overall scores were improved significantly (P < 0.01, respectively). The status of general psychiatric health was also improved significantly (P < 0.01).</p><p><b>CONCLUSIONS</b>Treatment of refractory IBS with subclinical dosage antidepressant is rational and effective, However a further study on its mechanisms is suggested.</p>