螺旋CT对腹部空腔脏器穿孔的诊断价值

The diagnostic value of spiral CT for abdominal hollow viscera perforation

目的探讨螺旋CT在腹部空腔脏器穿孔中的诊断价值。方法回顾性分析18例腹部空腔脏器穿孔的CT表现,所有病例经临床及手术证实。结果胃、十二指肠穿孔6例,空回肠穿孔6例,结肠穿孔4例,子宫积脓自发穿孔1例,膀胱自发性破裂1例。主要CT征象有:肝上间隙积气(14例)、肝下间隙积气(8例)、肝圆韧带裂隙积气(4例)、穿孔脏器局部积气(17例)、腹腔积液(13例)、肠壁局限性增厚(9例)。结论 CT可直观地显示腹膜腔、腹膜后腔游离气体,为临床提供及时准确的诊断,并可为明确穿孔部位、病因、合并症提供较多有价值的诊断信息。

Objective To evaluate the diagnostic value of spiral CT for abdominal hollow viscera perforation.Methods CT findings of 18 patients with abdominal hollow viscera perforation proved clinically and surgically were retrospectively analyzed.Results Spiral CT scans demonstrated that there were 6 gastroduodenal perforation,6 jejunoileal perforation,4 colonic perforation,1 uterus spontaneous perforation from uterine abscess and 1 bladder-spontaneous rupture.The CT signs of abdominal hollow viscera perforation mainly were suprahepatic space pneumatosis（n=14）,subhepatic space pneumatosis（n=8）,gas accumulation in the fissure of hepatic teres ligaments（n=4）.local gas accumulation around the perforated viscera（n=17）,ascites（n=13） and localized thickening of the intestinal walls（n=9）.Conclusion Spiral CT scan could directly show the free gas in peritoneal and retroperitoneal cavities and provide the important informations for timely dingnosing the site,cause and complication of the perforation.