Poster électronique

Hernies internes : les clés du diagnostic scanographique
D. Régent, V. Laurent, C. Barbary, S. Corby-Ciprian, E. Kermarrec, J. Mathias - Vandoeuvre-Lès-Nancy - France
Congrès 2007
Poster primé par le jury
Résumé
Objectifs
Préciser les modalités d’analyse des images scanographiques pour identifier les variétés classiques et plus rares de hernies internes (HI) de l’abdomen. Illustrer les principaux problèmes de diagnostic positif et différentiel scanographique des HI.
Matériels et méthodes
A partir d’un important matériel personnel et des formes rares publiées dans la littérature, les auteurs proposent une méthode d’analyse sémiologique simple et applicable au quotidien pour l’identification des principales formes de HI et leur différenciation des autres causes d’occlusion, en particulier des volvulus partiels du grêle sur bride ou adhérences.
Résultats
La présentation des HI dépend de leur modalité de constitution. Les HI développées dans un décollement péritonéal sont caractéristiques par leur englobement dans un sac sphérique (H para duodénales et intersigmoïdiennes). Les HI par incarcération d’anses dans un orifice d’un segment péritonéal mobile simulent un volvulus sur bride. C’est le siège du point de convergence des anses distendues qui permet de différencier les H transmésentériques des H transomentales ou des H du ligament falciforme. L’identification des structures vasculaires est un guide indispensable pour la caractérisation des HI.
Conclusion
Les HI de l’abdomen sont encore souvent des diagnostics opératoires. La qualité actuelle des images scanographiques multiplanaires permet d’améliorer très nettement nos capacités d’identification préchirurgicale, sous réserve d’une bonne connaissance de l’anatomie et de la physiopathologie des deux grands types de HI.
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2017-12-08 13.57 :
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2014-05-24 10.45 :
frey

Tb merci

2014-03-13 18.34 :
PUJOL

merci pour cet exposé tres pedagogique, un régal

2013-02-20 21.38 :
Tenoudji cohen

excellent travail. Encore bravo....
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