上消化道溃疡穿孔的超声表现及其定位诊断价值

Ultrasonic appearance and location diagnosis of peptic ulcer perforation

目的探讨上消化道溃疡穿孔的声像图表现及超声定位诊断的价值。方法回顾性分析31例经手术证实的上消化道溃疡穿孔患者的声像图资料。结果手术证实超声定位的31例上消化道溃疡穿孔部位全部符合。直接声像表现为局部胃窦或十二指肠球部壁全层中断,胃肠腔内外回声贯通,可见"漏斗征"、"通道征"声像图。间接声像表现有膈下游离气体、腹腔积液,穿孔断端向内塌陷,肝下间隙大网膜增厚包裹等。结论上消化道溃疡穿孔具有特征性声像图表现,超声弥补了X线检查无法定位的缺陷,对临床的诊断治疗具有重要意义。

Objective To evaluate the tdtrasonic appearance and the value of location diagnosis of peptic ulcer perforation. Methods The sonographic features in 31 cases with peptic ulcer perforation confmned by operation were analyzed retrospectively, partictdarly the sonographic features of perforation position. Results Ultrasonic location diagnosis was correspondent with the operation restdts in 31 cases. The tdtrasonic direct signs were as follow： the wall of stomach or duodenum was discontinuous and the echo inside and outside of stomach or intestinal cavity was continuous, two forms were divided： funnel sign and channel sign. The indirect signs were as follow： free air and free fluid existed in the abdomen, the end of perforation caved was inward collapsed, subhepatic space omentum majus was thickened. Conclusion The peptic ulcer perforation has characteristic sonographic features. Ultrasonography has the exceptional value for peptic ulcer perforation. It can make up for the defect of X - ray that eouldn＇ t locate the perforation, and play an important role for clinical diagnosis and treatment.