CT诊断闭孔疝合并小肠梗阻的临床价值

The Clinical Value of CT Diagnosis of Obturator Hernia Combined with Intestine Obstruction

目的:提高对闭孔疝合并肠梗阻CT影像特征认识,探讨CT诊断该疾病的临床价值。方法:回顾性分析已确诊的11例闭孔疝合并肠梗阻患者的临床和CT影像特征。结果:11例闭孔疝合并小肠梗阻病例中:左侧8例,右侧3例;11例病例均为中老年女性,均患有慢性阻塞性肺病。闭孔疝CT表现:9例梗阻点区域为较典型的鸟嘴征;闭膜管区疝囊颈呈小结节状改变,直径在4.7～9 mm,平均6.5 mm;疝囊体呈肿块或结节状改变,嵌顿在闭孔外肌和耻骨肌之间,闭孔外肌和耻骨肌被推压变形,疝囊短径12～27 mm,平均值为16.7 mm;长径为17～42 mm,平均值为26.5 mm;疝囊内容物均为嵌顿小肠;全部病例均有低位小肠机械性梗阻。闭孔疝合并缺血性肠病表现为疝囊体周围间隙积液,增强扫描肠壁强化程度明显减弱。结论:CT检查是诊断闭孔疝合并肠梗阻最敏感和最有效的检查手段,并具有典型CT影像特征,有重要临床价值。

Objective：To study the characteristic of CT imaging and to explore the clinical value of CT in diagnosis of disease. Method： Retrospectively analysed the clinical symptom and CT characteristics of the 11 cases of obturator hernia combined with intestine obstruction. Result： Of the 11 cases, 8 cases were left obstruction, while 3 cases were on the right. All the cases were old women with chronic obstructive pulmonary disease; CT imaging showed： 9 cases obstruction area had beak sign; sac neck of closed membrane tube area had small nodules, with diameters between 4.7 -9 mm, average of 6.5mm; sac body had bump or nodules, embedded between obturator muscle and pubic muscle, which had been pushed to disorganized shape, hernia sac had minor axis of 12 -27 mm, with average of 16.7 mm; major axis of 17 -42 mm ; all contents were full of small intestine; and all cases had intestine obstruction . Obturator hernia with small bowel obstruction had intesttiture hydropic effusion around sac body. Enhanced scan showed that the strength of the intestinal wall reduced obviously. Conclusion：CT examine is the most sensitive and effective method by typical CT images for obturator hernia with intestine obstruction. CT examine has important clinical value.