急性胃、十二指肠穿孔23例超声诊断与分析

Ultrasonic diagnosis and analysis of 23 cases of acute gastroduodenal perforation

目的评价急性胃、十二指肠穿孔的超声诊断价值,探讨如何提高超声诊断急性胃、十二指肠穿孔的准确性。方法回顾性抽查经手术或胃镜证实的急性胃、十二指肠穿孔病人的超声档案资料23份,分析总结其声像图表现,并就其超声诊断价值加以评议。结果23例急性胃、十二指肠穿孔病人中,超声检查发现有穿孔直接征象者15例,占65.2%,具有确定诊断价值,18例病人有腹腔积液的间接征象,占78.3%,其中5例仅有腹腔积液,约占21.7%,可提示临床进行腹穿定性。有典型胃、十二指肠穿孔表现,超声检查无异常声像改变者2例,误诊为胆囊炎者1例,二者约占13%。结论腹部超声检查尤其是彩超检查可为临床诊断急性胃、十二指肠穿孔提供重要的客观依据,应作为急性胃、十二指肠穿孔首选的检查方法。

Objective To evaluate the value of ultrasonic diagnos is of acute gastroduodenal perforation and to discuss how to elevate veracity of ultrasonic diagnosis of acute gastroduodenal perforation. Methods Ultrasonic archives of twentythree patients with acute gastroduodenal perforation proved by operation and gastroscope were reviewed and their ultrasound findings were analysed. Results In all of the cases there were fifteen patients with direct ultrasonic signs and eighteen patients with intraperitoneal fluid-one of indirect ultrasonic signs. Each of them accounted for sixty-five point two percent and seventyeight point three percent. Five patients were only found with celiac fluid which could lead a surgeon to make a celiac centesis. Two patients had no ultrasound findings, though they had typical clinical manifestation. One patient was misdiagnosed as cholecystitis. Conclusion Celiac uhrasonography should be the first means to diagnose acute gastroduodenal perforation, because it can provide some important objective evidences for surgeon.