钝性胰腺断裂伤的CT诊断  

CT Diagnosis of Blunt Pancreatic Horizontal Injury

作　　者：刘克昌 项光涨 陈光华 刘怡文[2] 周义成[3] 张崇法 曹晓青 

机构地区：[1]温州市龙湾区第一人民医院,浙江温州325024 [2]江苏大学附属宜兴医院 [3]华中科技大学同济医学院附属同济医院

出　　处：《实用放射学杂志》2009年第3期369-371,388,共4页Journal of Practical Radiology

摘　　要：目的探讨钝性胰腺断裂伤的CT表现。方法回顾性分析经手术证实的6例钝性胰腺断裂伤的CT表现及其特点,所有病例均行CT平扫,其中2例行增强扫描。结果胰颈断裂4例,胰头钩突断裂1例,胰体尾断裂1例。CT直接征象为胰腺断裂口,3例于断裂处呈现线条样或宽带状低密度影,与胰腺长轴接近垂直,平扫断裂口边界欠清,增强扫描断裂口边界清楚;3例在平扫上呈楔形不均匀高密度血肿表现。间接表现为创伤性急性胰腺炎：6例均见胰腺局部或弥漫性肿大及胰周积液（血）、网膜囊血肿3例、肾前筋膜增厚6例,腹腔积液5例,胃肠道积气4例,胰管轻度扩张2例;合并脾破裂及十二指肠损伤各1例。结论CT是诊断钝性胰腺断裂伤的首选方法。Objective To study CT manifestations of blunt pancreatic transectional injury. Methods CT findings of 6 patients with surgically proved pancreatic horizontal injury were retrospectively analyzed. All cases underwent CT plain scans of the abdomen and 2 cases underwent contrast-enhanced CT scans preoperatively. Results There were ruptures of pancreatic neck in 4 cases,pancreatic uncinate in 1 case and pancreatic body and tail in 1 case. The direct CT signs of pancreatic transectional injury were the gaps , which appeared as hypodense lines or band shadows perpendicular to the long axis of the pancreas with undefinite margins on plain CT scans and definite margins on post-contrast CT scan in 3 cases. The gaps on plain scans were manifested as wedge-shaped inhomogeneous hyperdense hematomas in 3 cases. The indirect signs were manifested as traumatic pancreatitis,including focal or diffuse pancreatic enlargement,peripancreatic fluid collections and thickening of the anterior pararenal fascia in all cases, hematomas in omental bursa in 3 cases, ascites in 5 cases, gastrointestinal pneumatosis in 4 cases, main pancreatic duct slight dilation in 2 cases. Meanwhile associated with contusion of the spleen and duodenum in 2 cases. Conclusion CT is an effective modality in diagnosing the pancreatic horizontal injury.

关 键 词：胰腺 创伤 体层摄影术 X线计算机 

分 类 号：R576[医药卫生—消化系统] R814.42[医药卫生—内科学]