腹部空腔脏器破裂穿孔的螺旋CT诊断价值  

Value of Spiral CT in the Diagnosis of Abdominal Hollow Viscera Perforation

作　　者：潘昌远 许茂盛[2] 

机构地区：[1]景宁县人民医院放射科,浙江323500 [2]浙江省中医院放射科

出　　处：《放射学实践》2009年第5期498-501,共4页Radiologic Practice

摘　　要：目的:探讨螺旋CT在腹部空腔脏器穿孔中的诊断价值。方法:回顾性分析经手术证实的15例腹部空腔脏器穿孔病例的CT表现。结果:胃十二指肠溃疡穿孔7例,腹部外伤致空回肠穿孔4例,肠结核穿孔、异物(硬鱼骨)致乙状结肠穿孔、粪块性乙状结肠穿孔及子宫积脓自发穿孔各1例,15例腹部空腔脏器穿孔的主要CT征象为剑突下隐窝积气(13例)、肝下肝圆韧带间隙积气(9例)、网膜囊积气(4例)、穿孔脏器周围局限性积气(11例)、腹膜后间隙积气(1例)、腹腔积液(11例)以及肠壁增厚(3例)等。CT可直观地显示脏器穿孔破裂口、异物等,准确地判断腹腔游离气体的有无、部位和多少,并能为穿孔部位、病因、合并症的诊断提供较多有价值的信息。结论:螺旋CT可较准确地诊断腹部空腔脏器穿孔,可作为腹部X线平片的重要补充。Objective：To investigate the diagnostic value of spiral CT in assessing abdominal hollow viscera perforation. Methods： Fifteen cases of abdominal hollow viscera perforation proved by surgery were retrospectively studied. Results： The causes of perforation included gastric and duodenal ulcer （7 cases）, small bowel trauma （4 cases）, tuberculosis （1 ease） , sigmoid colon perforation due to foreign body （fish bone） , fecalith and uterine abscess for 1 ease each. The main CT finding of these 15 patients was gas accumulation,which located in sub-xiphoid recess （13 cases）,in ligamentum teres fissure of liver （9 cases）,within onlentum sac （4 cases）,around perforated viscera （11 cases） and in retroperitoneal space （1 case）. Other signs included ascitis （11 cases） and bowel wall thickening （3 cases）. The location of abdominal hollow viscera rupture, foreign bodies as well as the existence, location and volume of free air within abdominal cavity could be directly and accurately demonstrated on spiral CT. CT provides valuable information about the location, cause of perforation as well as the diagnosis of complications. Conclusion： Abdominal hollow viscera perforations can be accurately diagnosed by spiral CT, which could be a valuable complementary technique following abdominal radiography.

关 键 词：空腔脏器穿孔 气腹 体层摄影术 X线计算机 

分 类 号：R656.1[医药卫生—急诊医学] R816.5[医药卫生—外科学]