胰腺急性损伤及其在随访复查中的MSCT表现

The MSCT Appearance of Acute Pancreatic Trauma and Follow-up

目的探讨胰腺急性损伤及其在随访复查中的MSCT表现。资料与方法回顾性分析13例胰腺急性损伤后的临床资料和33次MSCT检查资料。结果13例中,首次MSCT检查发现10例胰腺部分断裂,分别为胰体部6例,胰颈部4例,其中2例并血肿形成;1例为胰体部完全断裂。另2例胰腺呈挫伤表现,其中1例于胰头内出现囊肿。随访复查中,8例出现假性囊肿,均位于胰腺实质外,出现囊肿时间为5～38天,平均18天。继续随访复查中,1例患儿经保守治疗15天后,囊肿完全吸收;另1例采用外引流治疗41天后囊肿完全吸收;其余囊肿均缩小。结论MSCT能及时发现胰腺急性损伤并判断损伤程度,通过CT随访复查还能进一步观察胰腺损伤的演变过程,有利于指导临床治疗方案的选择和预后的判断。

Objective To study the MSCT appearance of acute pancreatic trauma and in the follow-up. Materials and Methods The clinical and CT data of 13 cases with pancreatic trauma were retrospective analyzed （male 10 cases,female 3 cases,age between 2.5-48 years old,the mean age was 21 years old）. Results In 13 cases,pancreatic dissection in 11 at the first examination,partly dissection in 10 cases （6 were in pancreatic body,4 in pancreatic neck,in which 2 had hematoma）; 1 completely dissection in pancreatic neck.Contusion was found in two cases,in which 1 had cyst in the parenchyma of pancreatic head. In follow-up examination,pancreatic pseudocysts were formed in 8 cases,all were in the periphery of pancreas. The cysts appeared between 5-38 days after trauma,mean time was 18 days. In the continue follow-up,one of child cases had expectant treatment,15 days later,the pseudo-cyst was completely Absorbed; another patient had internal draining treatment,41 days later,the pseudo-cyst was completely Absorbed. Conclusion MSCT examination can detect acute pancreatic trauma and evaluate its degree,it can also show the continuous changes in the follow-up examination,which were useful in conduction of choosing the clinical treatment and judging the prognoses.