术后早期炎症性肠梗阻的影像诊断  

Imaging Diagnosis of Early Postoperative Inflammatory Small Bowel Obstruction

作　　者：唐震[1] 陈峰[2] 施玲华 

机构地区：[1]上海市第六人民医院奉贤分院放射科,201400 [2]宁夏医科大学,银川研究生750004 [3]上海公利医院影像科,200050

出　　处：《临床放射学杂志》2011年第12期1788-1791,共4页Journal of Clinical Radiology

摘　　要：目的探讨术后早期炎症性肠梗阻(early postoperative inflammatory small bowel obstruction,EPISBO)的影像学表现,避免误诊。资料与方法分析21例EPISBO的影像表现,21例均行CT平扫,其中14例行CT增强扫描,8例行碘水溶性对比剂全胃肠道造影检查。结果 X线胃肠道造影表现:小肠扩张、气-液平面8例,肠间隙增宽5例,肠襻粘连成团3例,腹脂线模糊3例,2例见腹腔积液。7例见肠蠕动缓慢或消失、肠排空减慢,1例肠蠕动和肠排空基本正常。CT表现:肠管扩张21例,肠壁水肿、增厚14例,肠系膜浑浊、腹腔渗出14例,肠管广泛粘连16例,增强扫描8例肠壁强化。结论 EPISBO影像表现介于麻痹性肠梗阻和粘连性肠梗阻之间,肠动力减低明显时其表现类似麻痹性肠梗阻,而粘连为主时其影像表现偏向于粘连性肠梗阻。结合临床表现诊断不难,影像学检查主要是排除麻痹性肠梗阻、粘连性肠梗阻以及肠扭转等。Objective To improve the diagnosis of early postoperative imflammatory small bowel obstruction.Materials and Methods The image manifestations of early postoperative inflammatory small bowel ostruction（EPISBO） in 21 patients were retrospectively analyzed.All patients underwent plain CT scan,and 14 of them underwent enhance CT scan.Fluoroscopic examination of gastrointestinal tract with oral iodine were performed in 8 patients.Results X-ray findings： There were dilated loops of small bowels and air-fluid level in 8（8/8） cases.The space between bowels increased in 5（5/8） cases.Adhesive small bowels were lumping in 3（3/8） and abdomen fatty lines were obscure in 3（3/8）.In 7（7/8）,intestinal peristalsis and emptying function weakened.CT findings include dilated loops of bowel filled with gas and fluid in 21 cases,thickening and edema of intestinal walls in 14,muddy mesentery and effusion in abdomen cavity in 14,diffuse adhesion in 16.Enhancing intestinal walls were showed in 8 cases（8/14）.Conclusion The imaging findings of EPISBO may be similar to that of paralysis intestinal obstruction or adhesion intestinal obstruction.The purpose of imaging examination was to eliminate paralysis intestinal obstruction,adhesion intestinal obstruction and volvulus.

关 键 词：术后早期炎症性肠梗阻 X线 体层摄影术 X线计算机 手术后并发症 

分 类 号：R656.7[医药卫生—外科学]