超声诊断十二指肠球部溃疡穿孔

Ultrasonographic diagnosis of duodenal bulb ulcer combined with perforation

目的探讨十二指肠球部溃疡穿孔的超声表现特征,评价超声诊断十二指肠球部溃疡穿孔的价值。方法回顾性分析25例手术证实的十二指肠球部溃疡穿孔患者的彩色多普勒声像图特点,分别计算超声对十二指肠溃疡、腹腔游离气体、腹腔积液及局部包块的检出率,并与X线检查结果进行对比。结果25例十二指肠球部溃疡穿孔患者,术前超声检查提示十二指肠球部溃疡21例,腹腔游离气体18例,腹腔积液25例,腹部包块14例。X线平片或透视发现膈下游离气体21例,未能显示腹腔积液及腹部包块,更无法显示十二指肠球部溃疡的直接征象。结论对于十二指肠球部溃疡穿孔,超声在显示腹腔游离气体方面与X线检查相当,还可显示腹腔积液、肿块等X线无法显示的间接征象,尤其是可部分显示十二指肠球部溃疡的直接征象,弥补了X线检查的不足,是十二指肠球部溃疡穿孔的有效检查方法。

Objective To observe ultrasonographic features and the value of ultrasonography in diagnosing duodenal bulb ulcer combined with perforation.Methods The ultrasonographic features of duodenal bulb ulcer combined with perforation were studied retrospectively in 25 patients.The detection rate of duodenal bulb ulcer,peritoneal cavity free air,ascites and abdominal lumps were recorded and compared with those of X-ray examination.Results Color Doppler ultrasound before operation found 21 patients with duodenal bulb ulcer combined with perforation,18 with peritoneal cavity free air,25 with ascites and 14 with abdominal lumps.X-ray examination showed peritoneal cavity free air in 21 patients,but no ascites and abdominal lumps were found,let alone the direct features of duodenal bulb ulcer.Conclusion With regard to duodenal bulb ulcer combined with perforation,color Doppler ultrasound can not only display peritoneal cavity free air as well as X-ray,but also show ascites and abdominal lumps,even duodenal bulb ulcer itself.Color Doppler ultrasound can make up the deficiency of X-ray examination,and is a valuable method in diagnosing duodenal bulb ulcer combined with perforation.