急性上消化道穿孔的螺旋CT诊断

Diagnosis of Acute Upper Gastrointestinal Perforation with Spiral CT

目的探讨螺旋CT对急性上消化道穿孔的诊断价值。方法对49例经手术证实的急性上消化道穿孔患者的CT影像资料进行回顾性分析。结果 49例患者中,十二指肠溃疡穿孔33例(67.35%);胃溃疡穿孔16例(32.65%),其中胃窦前壁穿孔9例(56.25%),胃小弯前壁穿孔7例(43.75%)。腹腔游离气体49例(100.00%),腹腔积液46例(93.88%),胃肠道壁不规则增厚或周围脂肪层模糊23例(46.94%)。结论通过螺旋CT诊断上消化道穿孔的患者,可以明确患者穿孔的病灶,能弥补X线平片的不足,为临床外科急腹症提供快速而可靠的诊断依据。

Objective To explore the diagnostic value of spiral CT in acute upper gastrointestinal perforation.Methods CT image data of 49 patients with acute upper gastrointestinal perforation confirmed by surgery were retrospectively analyzed. Results Among the 49 patients, duodenal ulcer perforation was observed in 33 （67.35%）,gastric ulcer perforation in 16 （32.65%）,intraperitoneal free gas in 49 （100.00%）,ascites in 46 （93.88%）,and irregular thickening of digestive wall and fuzzy fatty layer in 23（46.94%）.Among the 16 patients with gastric ulcer perforation, perforation was located at anterior wall of the gastric antrum in 9 （56.25%） and at anterior wall of the lesser gastric curvature in 7 （43.75%）. Conclusion Spiral CT can confirm perforated lesions, make up the deficiency of radiology and provide rapid and reliable diagnosis in patients with acute upper gastrointestinal perforation.