多层螺旋CT在粪石性肠梗阻中的诊断价值

The assessment of small bowel obstruction due to bezoar by multi-slice spiral CT

目的观察粪石性肠梗阻的多层螺旋CT（MSCT）图像特点,并评估MSCT的诊断价值。方法回顾性分析我院5例粪石性肠梗阻患者的CT图像。结果手术取出粪石6枚,其中5枚位于回肠,1例患者同时发现胃粪石。粪石长径3~7 cm,所有粪石的共同CT特征为筛孔状气泡征及类圆形或卵圆形肿块,增强均出现梗阻部位肠壁强化;3例出现少量胸腹腔积液,3例复查粪石游走。结论 筛状气泡征是小肠粪石性肠梗阻的特征性表现。术前MSCT对粪石性肠梗阻的诊断很有价值,为临床外科手术提供依据。

Objective To observe the multi-slice spiral CT（MSCT） features of bezoar-induced small bowel obstruction and to assess the value of MSCT.Methods The MSCT findings and clinical data of the 5 cases which had bezoar-induced small bowel obstruction from our hospital were analyzed retrospectively.Results Surgery revealed five bezoars in the ileum and 1 case in the duodenum.One patient had bezoars found concurrendy in the stomach.The mean long-axis diameters of the bezoars ranged from 3.0 cm to 7.0 cm.All patients had the common CT findings as a mottled gas pattern and a focal ovoid or round intraluminal mass.By enhanced CT examination,there was obvious strengthened bowel wall in all cases.A small amount of pleural effusion and ascit were found in 3 cases.3 cases of bezoar had the wandering.Conclusion The mottled gas pattern has the characteristic feature of bezoar by MSCT.Preoperative CT is valuable for patients admitted with signs of intestinal obstruction.