胆石性肠梗阻的影像学诊断  

Imaging diagnosis of gallstone ileus

作　　者：陈恩龙[1] 赵振国[1] 隋海晶[1] 谢秀海[1] 钱帮伟[1] 黄玉章[1] 

机构地区：[1]上海市浦东新区人民医院放射科,201299

出　　处：《中华消化外科杂志》2014年第1期65-68,共4页Chinese Journal of Digestive Surgery

基　　金：上海市浦东新区卫生系统领先人才培养基金（PWR12010-02）

摘　　要：胆石性肠梗阻是一种罕见且具有潜在危险性的胆石症并发症，临床表现不典型，术前诊断困难。2005年3月至2012年9月上海市浦东新区人民医院收治了19例经手术或内镜检查证实的胆石性肠梗阻患者。患者术前X线片、超声、CT、MRI检查诊断准确率分别为0／10、0／5、19／19、9／9。CT检查可作为胆石性肠梗阻的首选检查方法。典型的CT表现为Rigler三联征：肠腔异位结石、机械性肠梗阻及胆道积气。MRI检查对瘘口的显示优于CT检查，可提供更为丰富全面的影像学信息，对手术方案的制订及预后的判断有重要参考价值；X线片及超声检查仅作为筛查手段。Gallstone ileus is a rare and potentially serious complication of cholelithiasis. Its clinical symptoms are non- specific. From March 2005 to September 2012, 19 patients with gallstone ileus confirmed by surgery or endoscopy were admitted to the Pudong New Area People＇s Hospital. The accuracies of X-ray, uhrasonography, CT and magnetic resonance imaging （MRI） were 0/10, 0/5, 19/19 and 9/9, respectively. CT examination might be the first choice for diagnosing gallstone ileus; the classical computed tomography （CT） presentation of gallstone fleus was the Rigler triad, including pneumobilia, ectopic stone and mechanical ileus; MRI examination was superior to CT examination in exposing the fistula, and can provide abundant information, which is important for designing the surgical procedures and judging the prognosis; X-ray and ultrasonography are beneficial in screening the diseases.

关 键 词：胆石症 肠梗阻 影像学诊断 

分 类 号：R574.62[医药卫生—消化系统]