胃肠道穿孔的CT诊断价值

CT Diagnostic Value of Gastrointestinal Perforation

目的：报道胃肠道穿孔的ＣＴ表现及其诊断价值。材料与方法：本组７例，术前均行多种体位的上腹部ＣＴ检查。结果：胃前壁穿孔３例，胃后壁穿孔２例，十二指肠球穿孔１例，降结肠穿孔１例。胃肠道穿孔的ＣＴ表现：直接征象有管壁不规则，周围脂肪层模糊；间接征象为腹腔内散在游离气体，以及穿孔引起的一系列并发症。结论：ＣＴ对临床症状较轻，Ｘ线透视膈下无游离气体者，特别是对胃后壁穿孔者有一定的诊断价值，而且优于其他影像学检查。

Objective: To report the CT appearences and the diagnostic value of the gastrointestinal perforation.Materials and Methods:7 cases of gastrointestinal perforation which upper abdominal CT scan was performed in various position before operation were reported. Results:It consisted perforation of anterior gastric wall 3 cases, posterior gastric wall 2, duodenal bulb 1 and perforation of descending colon 1. Three features of abdominal CT can be seen: (1) The direct features are irregular wall of gastrointestinal tract and blurring of the surrounding fat plane; (2) The indirect features are free gas within the abdorminal cavity and (3) features of a series of complications caused by the perforation. Conclusion: CT is valuable especially in the diagnosis of posterior gastric wall perforation and superior to other imaging modalities.