CT诊断胆肠瘘伴结石性肠梗阻9例分析  

The clinical value of CT examination in biliary-enteric fistula combined with stone ileus

作　　者：张小鸽[1] 

机构地区：[1]成都市第二人民医院,四川成都610017

出　　处：《实用医院临床杂志》2012年第5期166-167,共2页Practical Journal of Clinical Medicine

摘　　要：目的分析胆肠瘘伴结石性肠梗阻的CT影像特征,提高对该病的认识。方法回顾性分析经手术确诊的9例胆肠瘘伴结石性肠梗阻患者的CT影像资料。结果 9例患者CT征象为慢性胆囊炎合并胆囊周围炎表现:胆囊萎陷、变形,胆囊壁增厚,与周围结构分界不清,胆囊积气,1例合并肝内外胆道积气;9例均为小肠梗阻,其中6例为低位回肠梗阻,3例为空肠梗阻,梗阻小肠明显扩张积气、积液,伴有长短不等液平影征;9例梗阻胆结石直径1.9～2.6 cm,均呈环状高密度结节和肿块状改变。结论胆肠瘘伴结石性肠梗阻的CT影像特征具有特异性,CT是临床上最有价值的首选检查手段。Objective To analyze the CT image features of biliary-enteric fistula combined with stone ileus, and to improve the understanding of the disease. Methods CT imaging features of 9 cases with biliary-enteric fistula combined with stone ileus proved by surgery, were retrospectively analyzed. Results All 9 patients showed CT findings of chronic cholecystitis and inflammation around the gallbladder including collapse and deformation of gallbladder and thickening gallbladder wall, unclear delineation with surrounding structures, and gallbladder gas. One case was combined with extrahepatic bile duct gas. Nine cases of intestinal obstruction were small bowel obstruction,including 6 cases of low ileum obstruction,3 cases of jejunum obstruction. Pneumatosis and effusion and fluid level of variable length were observed in dilated small bowels. Diameter of gallstone caused ileus varied from 1. 9 cm to 2.6 cm in 9 cases, show- ing a ring-shaped and high-density nodule and mass-like change. Conclusion Characteristic CT features can be found in patients with biliary-enteric fistula combined with stone ileus. Therefore, CT is one of reliable imaging methods for diagnosis of this sort of disease.

关 键 词：胆肠瘘 结石性肠梗阻 CT 

分 类 号：R574.2[医药卫生—消化系统] R814.42[医药卫生—内科学]