Objective To investigate the characteristics and diagnostic value of multislice spiral CT (MSCT) of intestinal lipomas causing intussusception.Methods The MSCT findings of 25 cases with intestinal lipomas causing intussusception were retrospectively analyzed,the tumor location,size,shape,density,enhancement patterns and shape and length of intussusception were also observed retrospectively.Results Tumors were 1.2-6.5 cm in diameter,round or oval in shape (n =18),irregular shape (n =4),tubular shape (n =3) with uniform density (n =19),or uneven density (n =6).Under CT enhancement tumor capsule was moderately intensified.Intussusception included ileum-ileum type (n =7),jejunum-jejunum type (n =5),jejunum-ileum type (n =2),ileum-colon type (n =4),and colon-colon type (n =7).Intussusception was 5.0-5l.0 cm in length;presenting as concentric circles (n =12),round target sign (n =7),orbanana (n =6).Conclusion Intestinal liporna complicating secondary intussusception has definite MSCT characteristics which can help establish diagnosis.

Objective To investigate the characteristics and diagnostic value of multi-slice spiral computed tomography (MSCT) examination of gastrointestinal lipoma.Methods The cross-sectional study was adopted.The clinicopathological data of 96 patients with gastrointestinal lipoma including 32 from the Second Hospital Affiliated to Wenzhou Medical University,30 from the First Hospital Affiliated to Wenzhou Medical University,17 from the Ruian People's Hospital of Zhejiang,11 from the Yueqing People's Hospital,3 from the Wenzhou Central Hospital and 3 from the Wenzhou People's Hospital from December 2006 to September 2015 were collected.All patients were fasted for 8 hours prior to the examination,and partial patients underwent enhanced scan after the conventional CT scanning with breathless scanning and no abdominal pressure.Coronal and sagittal images of gastrointestinal tract including the tumor were administrated with multiple planar reconstruction (MPR)techniques of Reformat software.Based on MPR images,the curves along the gastrointestinal tract were drawn,voxel distributed along the curve track were reconstructed,and curved planar reconstruction (CPR) images were obtained.The patients received operation or follow-up according to individual characteristics after examinations.The patients undergoing operation were followed up for detecting tumor recurrence and metastasis by CT examination and patients receiving follow-up were observed by endoscopy for detecting changes of tumor size and morphology up to June 2015.The analysis indexes included tumor location and size,performance of MSCT examination (tumor shape,density,margin,intussusceptions,enhanced MSCT examination),intraoperative findings,results of pathological examination and results of follow-up.Measurement data with normal distribution were presented as i ± s.Results All the 96 patients received MSCT plain scan and the 42 received enhanced MSCT scan.The CPR images in 30 patients were collected.(1) Tumor location and size:3 tumors were located in the stomach,16 in the duodenal,27 in the jejunum,23 in the ileal,2 in the ileocecus,9 in the sigmoid colon,9 in the ascending colon,3 in the descending colon,3 in the transverse colon and 1 in the appendix.The diameter of tumor was (3.8 ± 2.3) cm.(2) Performance of MSCT examination:of the 96 patients,round or oval tumors were detected in 68 patients,tubular tumors in 15 patients and lobulated tumors in 13 patients.Tumors showed homogeneous density in 67 patients and inhomogeneous density in 29 patients.The CT value of tumors was-110--53 HU with a median value of-80 HU.Tumors of the 96 patients had clear boundaries and smooth margins.Twenty-four patients were complicated with intussusceptions with nested length of (28 ±4)cm,including 10 cases of multiple concentric rings,7 cases of double-target sign and 7 cases of banana sign.Enhanced MSCT scan showed that capsule around tumors in the 96 patients demonstrated slightly intensified,tumor body demonstrated no enhancement and that angiolipoma in 10 patients had cable strip like enhancement in the tumors.(3) Intraoperative findings:of the 96 patients,59 patients underwent surgical resection with single tumor,24 patients were concomitant with intussusceptions,9 patients showed aphtha in the center of tumors and 1 patient had partial lipoma in the prepyloric region dropped into the duodenal.Thirty-seven patients received endoscopic examination,showing submucous nodular protrusive lesions of 1.7-3.5 cm.(4) Results of pathological examination:of 59 patients undergoing surgical resection,submucosal,subserous and intramural tumors were detected in 45,9 and 5 patients,respectively,with complete capsule and pedunculated or non-pedunculated.Of the 59 patients,tumors showed round or oval shape in 41 patients,tubular shape in 10 patients and lobulated shape in 8 patients.The section of tumors showed yellowish-white.Specimens from endoscopic and surgical resections were observed under microscopy,the tumors were composed of mature-differentiated adipocytes,different quantities of fibrous connective tissues,blood vessels and mucus ingredients.Tumor cells were round shape with hypochromatic cytoplast and became polygeal and vacuolated after squeezing,nucleus was compressed to peripheral area and cytoplasm was full of lipid droplets.The results of immunohistochemistry stain showed Vimentin,CD34,D2-40,CD68 were positive and AE1/3 and Calretinin were negative.All tumors were diagnosed as benign lipomas.Fifty-nine patients who underwent surgical resection were followed up for 0.5-5.0 years and 37 patients of which specimens were obstained by endoscopic resection were followed up for 1.0-2.0 years after the pathological diagnosis with no significant change.Conclusion The MSCT finding of the gastrointestinal lipoma has characteristic appearance,and MSCT examination can clearly show lipoma location,size,shape and properties,with a widespread application value.

Objective To investigate the effect of laparoscopic Roux-en-Y gastric bypass(LYGB) on body fat distribution,and relationship between the changes of body fat distribution and improvement of insulin resistance.Methods A total of 65 patients with type 2 diabetes who underwent LYGB were selected for a retrospective analysis.Metabolic parameters,anthropometric measurements,body composition and fat distribution measured by dual-energy X-ray absorptiometry (DEXA) were collected separately before and 6 months post LYGB.All data of pre-and postoperation were compared with pair t test,Pearson correlation analysis was used to evaluate correlation of two variables.Results Weight,body mass index,waist circumference,waist-to-hip ratio,triglyceride,fasting plasma glucose,fasting insulin and homeostatic model assessment for insulin resistance (HOMA-IR) were significantly decreased in 6 months after surgery (P ＜ 0.05).Total fat mass,body fat mass of trunk,upper and lower limbs decreased significantly (P ＜0.05).Percent fat mass at the whole body,Android region,upper and lower limbs decreased significantly (P ＜0.05).After 6 months postoperatively,abdominal obesity indices waist circumfernce decreased from (98.10±13.03) cm to (91.60±7.68) cm (P＜0.01) and percent fat mass at the Android region decreased from (35.71 ±10.24)％ to (29.44 ± 12.11) ％ (P＜0.05),HOMA-IR decreased from 3.62 ± 5.18 to 1.79 ± 1.52 (P ＜ 0.05).The improvement of postoperative insulin resistance is positively correlated with the changes in waist circumference (P ＜0.01) and percent fat mass of Android region (P ＜0.05).Conclusions The body fat distribution changes after LYGB,change of abdominal fat distribution is positively correlated to the improvement of insulin resistance.

OBJECTIVE: To explore the application value of rectal prolapse constipation balloon in single auxiliary defecation. METHODS: Forty-one patients with moderate or severe rectocele were treated with a rectocele constipation balloon through the vagina. The defecography and VAS scores were compared before and after implantation. RESULTS: There was a significant difference between the anorectal angle, rectocele, and VAS scores before and after intervention in defecography (<0.01). CONCLUSIONS A single assisted defecation of the rectocelicular constipation balloon is feasible.
Constipation ; diagnosis ; Defecation ; Defecography ; instrumentation ; Female ; Humans ; Rectal Prolapse ; Rectocele