胃十二指肠溃疡穿孔的CT表现

CT Diagnosis of Gastroduodenal Perforation secondary to Peptic Ulcer

目的：探讨胃十二指肠溃疡穿孔的CT表现及其诊断价值。材料与方法：回顾性分析5例经手术病理证实的胃十二指肠溃疡穿孔者的CT表现。结果：本组5例中，急、亚急性穿孔4例，慢性穿孔1例。穿孔部位包括：胃窦小弯侧1例，胃体大弯侧1例，十二指肠球部上壁及前壁各1例，十二指肠球后部后壁1例。溃疡穿孔的CT表现；定性征象有腹腔内游离气体；定位片像有局部管壁增厚，不规则，周围脂肪层模糊；同时能全面地显示穿孔后腹腔内的继发改变。本组5例中有3例未能确定穿孔部位。结论：CT对诊断胃十二指肠溃疡穿孔很有价值，优于其它影像学检查，但对部分急性穿孔的定应诊断、慢性穿孔的定性诊断有一定限度。

Purpose:To study the CT appearance and the diagnostic value of gasttoduodenal perforation due to peptic ulcer diseases. Materials and Methods: 5 cases of gastroduodenal perforation due to peptic ulcer diseases proved by operation and pathology were analyzed retropectively. Results: It consists 4 cases of acute and subacute perforation, 1 case of chronic perfora-tion. The sites include: lesser curvature of gastric antrum wall, great curvature of body, anterior and upper dnodenum bulb wall,posterior postbulb wall. CT features include: (1) nature diagnostic feature is free gas in abdominal cavity; (2) site diagnostic fea-tures include bowel-wall irregular, thickening and discontinuous, blurring of the surrounding fat plane; (3) features of a series complications callsed by perforation could be indicate integratively. The precise site of perforation could not be detect in 3 cas-es. Concluslon: CT is valuable in detect gastroduodenal perforation secondary to peptic ulcer diseases and superior to other modali-ties, but is limited in detect the precise site of acute and subacute perforation, the nature of chronic perforation.