外伤性膈疝的X线CT表现与临床对照

X-ray,CT manifestations and clinical comparison of traumatic diaphragmatic hernia

目的加深对膈疝的临床X线和CT征象的认识及影像检查方法的选择。方法回顾性分析了本院收治的14例患者,将其X线CT表现与临床所见相对照。结果X线和CT检查共发现14例膈疝患者,包括左侧膈疝者13例,右侧膈疝1例。左侧膈疝患者中11例为胃疝,另外1例为大网膜疝,1例为肠道和大网膜疝;11例胃疝者中,9例合并肠道和大网膜疝,1例合并大网膜疝,2例合并肠道疝,2例合并肝疝,2例合并脾疝;1例右侧膈疝者疝内容物为部分肝右叶及肠道,与手术所见一致。结论胸腹部X线平片、钡餐检查及胸部上腹部CT扫描不仅能对膈疝做出正确的诊断,而且对临床手术指导具有重要的临床治疗意义。

Objective To explore the manifestations of X-ray and CT of traumatic diaphragmatic hernia. Methods 14 patients with traumatic diaphragmatic hernia were analyzed retrospectively and the characteristics of X-ray and CT were compared with clinical findings. Results Diaphragmatic hernia was found in all the 14 patients with X-ray and CT, of whom 13 were in left diaphragmatic hernia and 1 was in right diaphragmatic hernia. 11 patients with stomach hernia, 1 omentum hernia and 1 intestines and omentum hernia were discovered in 13 cases with left diaphragmatic hernia. Among 11 cases with stomach hernia, 9 with intestines and omentum hernia, 1 with omentum hernia, 2 with intestines hernia, 2 with liver hernia, 2 with spleen hernia were found. Right diaphragmatic hernia in 1 case was liver hernia. The findings of X-ray and CT were in accordance with that of operation. Conclusion X-ray, barium meal and CT are of great value to the accurate diagnosis and clinical operation of diaphragmatic hernia.