X线及CT联合应用对胆石性肠梗阻的诊断价值

Clinical value of combined application of X-ray and CT for diagnosis of gallstone ileus

目的：探讨X线及CT联合应用对胆石性肠梗的阻诊断价值。方法：回顾性分析10例胆石性肠梗阻患者的X线及CT表现。结果：10例患者中2例胆结石位于十二指肠，4例胆结石位于空肠，3例胆结石位于回肠，1例胆结石位于横结肠，结石直径2．5～6．5cn2，平均3．5cm；4例出现胆囊一十二指肠瘘，1例出现胆囊一结肠瘘，1例出现胆囊一十二指肠一结肠复合瘘，瘘口平均直径约1．5cm，其影像学表现包括肠管扩张积气积液、梗阻段肠腔内环形高密度结石影、胆囊积气及消化道造影剂外漏。结论：X线及CT联合应用可明确诊断胆石性肠梗阻，为临床治疗提供重要信息。

Objective：To discuss the clinical value of combined application of X-ray and CT for diagnosis of gallstone ileus. Methods： 10 cases of patients diagnosed as gallstone ileus with X-ray and CT imaging between 2011--2013 were collected and analyzed retrospectively. Results：Gallstones were found in 10 patients, 2 in the duodenum, 4 in the jejunum, 3 in the ileum and 1 in the transverse colon. Diameters of stones were 2.5---6.5cm,with an average of 3.5cm. There appeared gallbladder-colon-fistula in 4 cases,gallbladder-duodenum-fistula in one, gallbladder-duodenum-colon-fistula in one, the aver age diameter of fistula was 1.5cm. Their imaging manifestations included intesinal dilation with gas and fluid collection, gall stone in the obstructed intesine, pneumo-gallbladder and leakage of contrast agent in the digestive tract. Conclusion： Combined X-ray and CT scan can confirm the diagnosis of gallstone ileus with high clinical value for its treatment planning.