腹腔中空脏器穿孔的CT诊断

CT Diagnosis of Hollow Viscera Perforation of the Abdomen

目的:探讨腹腔中空脏器穿孔的各种CT征象及诊断价值。方法:分析32例腹腔中空脏器穿孔的 CT表现,29例作CT平扫,3例作增强扫描,全部病例经手术病理证实。结果:32例中发现腹腔游离气体 21 例(65%),腹腔游离积液27例(85%),大网膜及肠系膜改变14例(44%),脓肿2例,血肿3例,肠郁胀积气 3 例,胃扩张 1 例,胸水 2 例,左肾筋膜增厚1例,骨折1例。结论:腹腔游离气体,腹腔游离积液、大网膜及肠系膜改变是腹腔中空脏器穿孔的主要 CT表现。结合临床并综合分析各种CT征象能够及时、正确地作出定性诊断。

Objective:To discuss the manifestations and diagnostic value of CT in the hollow viscera perforation of the abdomen.Methods:CT findings in 32 cases with hollow viscera perforation of th abdomen were analyzed.29 cases were examined with CT plain scanning and 3 cases were examined addionally after injection of contrast materials.All of the cases were proved by operation and pathology.Results:Free gas in abdomen was seen in 21 cases (65%) and free effusion was seeen in 27 cases (85%).There were changes of the greater omentum and mesentery (n=14,44%),abscess (n=2),hematoma (n=3),distention of intestinal loops (n=3),dilatation of stomach (n=1),pleural effusion (n=2),thickening of left renal fasica (n=1) and fracture (n=1).Conclusion:The main CT signs of the hollow viscera perforation of the abdomen include free gas,free effusion and changes of the greater omentum and mesentery.In combination with clinical data and CT findings, correct dignosis can be made.