外伤性急性胰腺炎CT表现与临床症状对照分析

Contrast between CT manifestations and Clinic symptom of Traumatic and acute pancreatitis

目的 探索外伤性急性胰腺炎的CT表现与临床症状相关性。资料与方法:搜集1999年-2002年经手术证实外伤性急性胰腺炎病例10例。男性8例,女性1例,儿童1例,年龄在10-45岁之间,平均31岁,均采用EG9800CT薄层1.5cm-3.0cm横断面多次扫描,结合临床症状、体检和诊断性腹部穿刺及临床手术所见,观察和评价外伤性急性胰腺炎的胰腺形态,特征及胰腺周围组织改变等并发症的CT表现特点。结果 10例外伤性急性胰腺炎中有9例均为复合性外伤,1例单-腹部外伤,临床表现有8例不同程度腹痛、腹胀、恶心呕吐。有2例无明显腹部症状,经诊断性腹穿10例均为阳性,手术证实;3例胰腺头挫伤,5例胰体部挫伤,2例胰头体部挫伤合并十二指肠降部穿孔,外伤性急性胰腺炎的CT征象:10例胰腺形态肿大、结构不清(12小时后),大量腹腔潴留液、小网膜囊积液,胰腺头体部血肿3例,假性囊肿2例,腹腔内游离气体2例。化验室检查,白细胞增多,血、尿淀粉酶增高。结论 外伤性急性胰腺炎;部份存在复合性外伤。早期腹部症状并不典型,24-48小时后出现临床主要症状为持继性腹痛、腹胀、发热、进行性大量腹水。CT表现主要胰腺结构不清、血肿.周边粘连、大量腹水及小网膜囊内积液,假性囊肿形成。

objective To Seeking for the relevance of CT manifestations and Clinic symptom of Traumatic and acute pancreatitis. Materials and Methods Collecting 10 eases of Traumatic and acute pancreatitis during 1999-2002, which have been proved to be after surgery. 8 male, 1 femal, 1 child, ages ranging from 10 to 45, and average age is 31 . In all of these cases, EG9800 CT layer (1.5) scan on transect were performed. Contrasting what can be seen in surgery, observe and assess CT manifestations of the status, characters of Traumatic and acute pancreatitis, and the syndrome such as changes of tissues in pancreas area. Results Within 10 cases of Traumatic and acute pancreatitis, 8 cases appear colic and vomit in different degree, 2 cases appear no obvious colic. In 3 cases, head and neck of pancreas get injured. In 5 cases perforation happened with pancreas body and descending part of duodenum combined; in 2 cases same happened with head and neck of pancreas and descending part of duodenum combined as well -familiar CT manifestations of Traumatic and acute pancreatitis. In 10 cases, shape of pancreas turned to be swelled, structure turned to be unclear(afterl2 hours); in 3 cases, hematoma happened with head and neck of pancreas; in 10 cases, lots of retention liquid retained in abdominal cavity and dropsy happened with sac of lesser omentum as well. In 2 cases pseudocyst found; and in another 2 cases, free gas found in abdominal cavity. Per assay, results shows leukocytosis, and amylomyces increase in blood and urina. Conclusion For Traumatic and acute pancreatitis, basic clinic symptoms are persistent colic,.fever, and ascites in plenty;CT manifestations show unclear basic pancreas structure, haematoma, periphery accreting, ascites in plenty, and dropsy in sac of lesser omentum, and pseudocyst formed.