CT在消化道穿孔早期诊断中的价值

Value of CT in Early Diagnosis of Gastrointestinal Perforation

目的:探讨CT在消化道穿孔早期诊断中的价值。方法:回顾分析经手术证实的27例消化道穿孔患者的CT表现。结果:穿孔部位包括胃、十二指肠穿孔17例,空、回肠穿孔7例,结肠穿孔3例。穿孔原因包括消化性溃疡16例,肿瘤2例,非特异性炎性反应(溃疡型结肠炎、克罗恩病)4例,肠伤寒1例,肠系膜扭转2例,外伤2例。手术前CT正确定位24例,正确率为88.9%。CT表现为腹腔内游离气体、腹腔积液、肠壁增厚及穿孔局部周围脂肪间隙模糊。结论:CT对早期诊断消化道穿孔有重要价值。

Objective：To investigate the value of CT in early diagnosis of gastrointestinal perforation.Methods：A total of 27 patients with gastrointestinal perforation proved by surgery underwent CT scanning.Results：There were 17 patients with gastric or duodenal perforation,7 patients with small bowel perforation and3 patients with colonic perforation.The causes of perforation were peptic ulcer（16 patients）,tumors（2 patients）,nonspecific inflammation including ulcerative colitis and Crohn′s disease（4 patients）,typhoid（1 patient）,reversion of mesenteric membrane（2 patients）and traumas（2 patients）.The accuracy of CT was 88.9%（24/27）for perforation locating before surgery.The main CT signs of gastrointestinal perforation were gas accumulation,ascitis,bowel wall thickening and fat stranding.Conclusions：CT is important for early diagnosis of gastrointestinal perforation.