腹部闭合创伤性小肠、结肠破裂的CT征象分析

CT Investigation of Small Intestinal and Colon Rupture in Closed Abdominal Trauma

目的:探讨腹部闭合创伤性小肠、结肠破裂的CT影像学特点,提高术前准确诊断率。材料与方法:回顾性分析216例经手术证实的创伤性小肠、结肠破裂病人的临床及CT影像学资料,总结其CT影像学特点。结果:经手术证实小肠破裂186例,结肠破裂30例。CT影像学表现包括腹腔积血、积液210例,腹腔游离气体172例,肠壁增厚、血肿120例,肠系膜损伤64例,合并其他实质性脏器损伤40例。腹腔积血、积液出现率最高,但缺乏特异性;腹腔游离气体特异性最高;肠壁增厚、血肿对肠道破裂具有较高的定位价值。结论:创伤性小肠、结肠破裂具有典型的CT影像学表现,CT对诊断创伤性小肠、结肠破裂具有较高诊断价值。

Purpose： To investigate CT imaging characteristics of small intestinal and colon rupture in closed abdominal trauma. Materials and Methods： Clinical and imaging data of 216 cases with small intestinal and colon rupture in closed abdominal trauma confirmed by surgical operation were retrospectively analyzed and the CT diagnosis points were summarized.Results： 186 cases small intestinal rupture and 30 cases of colon rupture were confirmed by surgical operation. In CT imaging,172 cased were found intra-abdominal free gas,210 cases were found abdominal cavity effusion or hematoma,120 cases were found thickening of hematoma of intestinal of colon wall,64 cases were found mesenteric trauma and 40 cases were combined with trauma of other parenchymatous organs. In the characteristics of small intestinal and colon rupture in closed abdominal trauma,abdominal cavity effusion or hematoma was the highest rate of occurrence,but lacked of specificity. The highest specificity was intra-abdominal free gas,and thickening or hematoma of bowel wall had high value orientation of intestinal rupture. Conclusion： There are some specific imaging characteristics of small intestinal and colon rupture in closed abdominal trauma,and CT has high diagnosis value for small intestinal and colon rupture in abdominal trauma.