螺旋CT对腹外疝所致肠梗阻的应用价值

Application value of spiral CT in bowel obstruction induced incarcerated abdominal external hernia

目的探讨嵌顿性腹外疝所致肠梗阻的螺旋CT表现。方法回顾性分析经手术证实的14例嵌顿性腹外疝所致肠梗阻的螺旋CT影像表现，并与手术结果对照分析。结果所有肠梗阻病例均观察到疝囊影，其中12例明确了疝的部位和种类，10例显示疝囊内存在肠管影，1例显示疝囊内有网膜存在，3例显示疝囊内呈均匀软组织密度影，4例显示疝囊内肠管壁增厚（其中2例出现分层）；显示腹腔肠管壁增厚2例，腹腔积液3例，肠扭转2例。结论螺旋CT在确定嵌顿性腹外疝所致肠梗阻的位置、疝囊内容物种类、疝囊内及梗阻近端肠管的血液供应情况及其他并发症方面有重要价值。

Objective To discuss the spiral CT features of the bowel obstruction induced incarcerated abdominal external hernia and its value in clinical application. Methods The spiral CT feature of the bowel obstruction induced incarcerated abdominal external hernia which were confirmed by surgery in 14 cases were retrospectively analyzed and were compared with surgical results. Results The hernia sac of incarcerated abdominal extemal hernia in all cases of bowel obstruction were displayed by CT, in which the positions and varieties of the hernia were determined in 12 cases,the intestinal images within the hernia sac were displayed in 10 cases, the epiploon image within the hernia sac was displayed in 1 case, homogeneus soft tissue density shadows were displayed in 3 cases, the intestinal wall thickening within the hernia sac was displayed in 4 cases,in which in 2 cases were involved in delamination of the intestinal wall. The intestinal wall thickening in abdominal cavity was displayed in 2 cases, the fluidify in abdominal cavity was displayed in 3 cases, the volvulus was displayed in 2 cases. Conclusion The spiral CT has an important value in determing the positions of bowel obstruction, varieties of the contents of hernia sac, the blood supply of the bowel within the hernia sac and proximate obstruction and other complications.