急诊CT对小肠植物性粪石梗阻的诊断价值

目的探讨植物性粪石致急性小肠梗阻的CT表现及诊断价值。方法回顾性分析经外科手术证实的19例植物性粪石致急性小肠梗阻的临床资料及术前CT表现。结果本组19例术前CT影像均显示粪石呈边缘清楚的卵圆形或圆形,其内密度不均或夹有小气泡影的软组织包块影。手术证实14例(73.7%)为单发粪石,5例(26.3%)为多发粪石;共取出粪石27枚,其中位于回肠16枚(59.3%),空肠8枚(29.6%),胃2枚(7.4%),十二指肠1枚(3.7%)。结论小肠植物性粪石CT影像具有特征性表现,可明确粪石数量及部位,是诊断植物性粪石致急性小肠梗阻的有效方法。

Value of Emergency CT in Diagnosis of Small Bowel Obstruction Induced by Vegetality Fecalith

Objective To explore the computed tomography（ CT） findings and diagnostic value of acute small bowel obstruction induced by vegetality fecalith. Methods Clinical data and preoperative CT findings of 19 patients with acute small bowel obstruction induced by vegetality fecalith confirmed by surgical means were retrospectively analyzed. Results The preoperative CT findings showed that stone edges were clear ovoid or round with uneven density or balloon-like soft tissue mass shadow. A total of 14 cases（ 73. 7%） of single fecalith and 5 cases（ 26. 3%） of multiple fecalith were confirmed by surgical means; 27 pieces of fecalith were removed,including 16 cases（ 59. 3%） in the ileum,8 cases（ 29. 6%） in jejunum,2 cases（ 7. 4%） in stomach and 1 case（ 3. 7%） in duodenum. Conclusion CT findings of enteric vegetality fecalith are specific,and can exactly locate the number and position of fecalith,so it is an effective method in diagnosis of acute small bowel obstruction induced by vegetality fecalith.