不可复性食管裂孔疝胸部X线表现及误诊

Thoracic X-ray Findings and Misdiagnosis of Irreducible Hiatus Hernia

回顾分析了12例经上消化道造影证实的不可复性食管裂孔疝胸部X线表现,其主要征象为心后区团块状阴影(2/12),厚壁空洞伴液平(6/12),单纯空洞(2/12)及心影下部密度增高(2/12)。疝囊与膈肌不能分开,其最大直径达9.4cm。提出了有诊断价值的X线征象,简述了与周围型肺癌、肺脓肿等病变的鉴别要点,同时分析了误诊原因,指出胸部高电压摄影和透视检查对显示疝囊和鉴别诊断均有重要价值。

Thoracic X-ray findings of 12 cases of irreducible hiatus hernia confirmed by contrast examina- tion of upper digestive tract were analyzed retrospectively. The hernial sac principally appeared to be a phymatoid shadow (2/12) ,thick wall cavity with a gas-liquid plane ( 6/12 ), simple cavity (2/12)and increase in density of the lower part of the heart(2/12) tin the postcardial area. They can not be separated with the diaphragm. The diameter of the maximal hernial sac is 9. 4 cm. The valuable X-ray features in diagnosis were given out. The primary points of differentiating diagnosis to the peripheral type pulmonary carcinoma and the abscess of lung,and so on,were also briefly discussed. Meanwhile the misdiagnosis causes were also analyzed. It was pointed out that the high kilovolt photograph and fluoroscopy of chest had important value in displaying hernial sac and differential diagnosis.