高频超声诊断肠脂垂炎7例临床分析

目的 分析高频超声诊断肠脂垂炎声像图特征及其临床价值.方法 对急腹症低频超声检查阴性而有明确压痛点的患者,用高频超声扫查,总结其声像图特征,并与CT及病理对照,评价其临床价值.结果 本组 7 例高频超声发现腹腔与腹壁粘连的高回声肿块,边界清,内呈面团状或云朵状结构,拟诊肠脂垂炎.CT检查6 例肠脂垂炎,1 例阑尾脓肿.病理诊断结果:6 例肠脂垂炎,1 例大网膜梗塞.超声和 CT 各误诊 1 例,1 例手术治疗,6 例保守治疗.结论 肠脂垂炎高频声像图有典型特征,可弥补低频超声不足,超声诊断本病与 CT 同样具有较高敏感性和特异性,为临床诊断和治疗提供可靠的影像学依据,减少漏诊误诊,避免不必要的手术损伤.     

肠脂垂炎的超声表现

目的：分析肠脂垂炎的超声表现,提高超声的诊断正确率。方法：回顾性分析17例肠脂垂炎的超声图像,观察病灶包块的边界、形态、内部回声、部位、彩色血流及与腹壁的粘连情况等。结果：17例病灶形态可呈圆形、椭圆形或不规则形;内部回声水平与病程的发展及就诊时间有一定的关联性;包块位于回盲部2例、升结肠旁3例、降结肠旁3例、乙状结肠旁9例;病灶内无或仅有少许血流信号;13例与腹壁粘连,4例与腹壁不粘连。结论：肠脂垂炎有较典型的超声表现,超声检查可以明确该病的诊断。     

CT诊断原发性肠脂垂炎的应用

目的:探讨CT诊断原发性肠脂垂炎的应用价值.方法:选取2019年5月—2021年5月新疆维吾尔自治区人民医院收治的94例原发性肠脂垂炎患者,对其临床资料进行回顾性分析,对病变部位、大小、形态、密度及周边情况进行分析.结果:94例原发性肠脂垂炎患者中,包括急性阑尾炎17例、胆囊炎20例、憩室炎21例、腹痛待查36例.通过...     

肠系膜脂膜炎6例CT及MRI诊断分析

目的 探讨肠系膜脂膜炎的CT及MRI表现,提高对该病的认识.方法 回顾分析6例肠系膜脂膜炎的影像学表现,4例经CT检查,2例经MRI检查.3例经病理证实,3例按照CT标准做出诊断.结果 所有肠系膜脂膜炎均为起自肠系膜根部,围绕系膜血管的肿块,可见雾状肠系膜和(或)“脂肪环”征和(或)“假包膜”征.结论 肠系膜脂膜炎CT及MRI表现有一定特征性,结合临床资料,CT及MRI对该病的诊断具有重要价值.     

胰腺及胰周淋巴结结核的CT诊断价值

目的探讨胰腺及胰周淋巴结结核的影像学表现，评价影像学检查对其诊断价值。方法搜集经手术病理或临床追踪证实的2例胰腺结核及11例胰周淋巴结结核病例，其中13例均作螺旋CT平扫及增强扫描。2例行MRI平扫及增强扫描。回顾性分析和总结其CT和MRI表现。结果2例胰腺结核位于胰头，CT表现为低密度肿块伴有周边蜂房状强化。11例胰周淋巴结结核中，7例CT平扫淋巴结肿大，部分融合成块；增强扫描孤立结节呈环形强化，融合成块者呈花环样强化。2例淋巴结全部钙化。另外2例同时存在以上两种征象。13例中，5例合并有脾脏结核的CT表现。结论胰腺及胰周淋巴结结核CT表现最常见是胰腺内局灶性蜂房状强化的肿块及低密度的胰周淋巴结肿大伴周边环形强化或钙化，可合并脾结核，CT、MRI表现较有特征性。     

急性肠脂垂炎的临床及CT影像特征分析

目的总结急性肠脂垂炎患者的临床及CT影像学特征。方法回顾性分析10例急性肠脂垂炎患者的临床及CT检查结果。结果 10例患者临床表现为左下腹痛8例,下腹部中央区痛1例,右下腹痛1例。CT平扫示病灶位于乙状结肠近端前方8例,乙状结肠远端1例,升结肠旁1例;病灶大小9 mm×12 mm～13 mm×26 mm;表现为紧邻肠壁的卵圆形脂肪密度灶,周围伴软组织密度环,周围见少许渗出影9例,邻近腹膜增厚9例,局部肠壁均未见明显增厚。10例均给予镇痛、敏感抗生素治疗,7 d后临床症状减轻或消失,复查CT示病灶消退。结论急性肠脂垂炎病灶多位于乙状结肠近端前方,临床以左下腹痛多见,CT平扫可见紧邻肠壁的卵圆形脂肪密度灶、周围伴软组织密度环,并可见渗出影、腹膜有增厚,一般预后较好。     

超声对原发性肠脂垂炎的检查价值

目的 探索超声对原发性肠脂垂炎的检查价值.方法 回顾性分析37例经随访证实的原发性肠脂垂炎的超声表现,观察病变部位、内部回声、大小、边界及血流分布.结果 37例原发性肠脂垂炎均发生于结肠侧旁,其中位于盲肠周围3例,升结肠周围4例,降结肠周围4例,乙状结肠周围26例.超声声像图特征表现为偏高回声包块,呈倒三角形或椭圆型,边界欠清,平均长径(3.9±0.9) cm,平均厚度(2.3±0.8) cm,彩色多普勒包块内未发现明显的血流信号,部分病例周边可见少量血流信号.结论 原发性肠脂垂炎超声表现有其特征性,结合临床表现容易作出提示诊断.     

邻关节骨囊肿的影像诊断与鉴别诊断

目的：探讨邻关节骨囊肿的发病机制、临床特征及影像诊断与鉴别诊断价值。材料与方法：对病理证实的14例邻关节骨囊肿的资料进行回顾性分析。全部病例术前均行X线摄片,其中11例行CT扫描及MPR检查,8例行MR检查。结果：影像特征表现为邻近关节面的骨内圆形、不规则形病灶,单房或多房,边缘清晰,相邻关节无明显异常。病变于X线平片及CT上表现为低密度透亮区,伴有薄环形硬化边。X线平片、CT分别发现1个、3个病灶与关节腔相通。2个病灶内CT发现有气体影。MRI表现为长T1长T2信号,压脂序列呈高信号,边缘伴环形低信号带。结论：邻关节骨囊肿具有一定的影像学特征,综合X线、CT、MR检查可提高对病变诊断的准确率。     

创伤性膝关节脂血症的CT、MRI表现

目的：探讨创伤性膝关节脂血症的CT及MRI影像学特点及其诊断价值。方法：回顾性分析45例创伤性膝关节脂血症的CT及MRI影像学表现,患者均于伤后2h~4d接受CT及MRI检查。结果：创伤性膝关节脂血症的CT及MRI表现为关节囊内特征性的液-液平面,26例表现为单液-液平面,19例表现为双液-液平面,且上层均表现为脂肪密度或信号。45例均存在关节内骨折。结论：创伤性膝关节脂血症在CT和MRI上具有特征性的影像学表现,可作为关节内骨折的可靠征像。     

急性坏死性肠脂垂炎误诊为急性兰尾炎2例报告

近年来,随着临床检查手段的提高,多数急腹症病人术前均能明确诊断,但仍有一些少见且不为临床重视的疾病术前很难做出正确诊断,即使术中探查仔细也有漏诊的可能,如坏死性肠脂垂炎。现将我院近1年收治的急性坏死性肠脂垂炎2例报告如下,供外科同仁借鉴。     

Gray-scale and color Doppler sonographic diagnosis of epiploic appendagitis

Depending on its location, epiploic appendagitis may mimic nearly any acute abdominal condition. We present the case of a patient with left lower quadrant pain. Sonography demonstrated an ovoid, hyperechoic, noncompressible lesion at the point of tenderness but no inflammatory changes in the adjacent colonic wall. Color Doppler sonography showed no flow in the lesion. Based on the sonographic diagnosis of epiploic appendagitis, conservative treatment was given, with complete recovery in 5 days. Awareness of these sonographic findings may aid in the early diagnosis of epiploic appendagitis and avoid unnecessary treatment.     

CT of diverticulitis and alternative conditions.

The clinical diagnosis of diverticulitis is often uncertain and frequently incorrect. Diagnostic imaging such as with helical CT offers a rapid and accurate diagnosis of diverticulitis and its complications as well as alternative conditions. In particular, helical CT combined with contrast material administered through the colon is highly accurate and can be obtained quickly. CT signs of diverticulitis include focal inflammatory wall thickening and paracolic inflammation superimposed on diverticular disease (diverticula, muscular wall hypertrophy). Common alternative conditions that can clinically mimic diverticulitis include small bowel obstruction, primary epiploic appendagitis, acute cholecystitis, appendicitis, ileitis, ovarian cystic disease, and ureteral stone disease. Early and frequent use of diverticular CT promises to improve diagnosis and treatment of patients with clinically suspected diverticulitis.     

Epiploic appendagitis of the rectosigmoid junction: demonstration with transrectal sonography

A 24-year-old man presented with lower abdominal pain that had been present for 18 hours. Physical examination revealed mild tenderness in the lower abdomen. Digital rectal examination revealed a tender point approximately 9 cm above the anal verge. Transrectal sonographic examination demonstrated an ovoid echogenic noncompressible mass surrounded by a hypoechoic halo attached to the wall of the rectosigmoid junction. A diagnosis of epiploic appendagitis was made on the basis of sonographic findings and was subsequently confirmed with contrast-enhanced CT.     

Epiploic appendagitis: a new diagnosis for the emergency physician. Two case reports and a review.

Two cases of epiploic appendagitis are presented. One was mistaken for acute appendicitis, the other for acute diverticulitis. In both cases, the correct diagnosis was made in the operating suite. With the aid of contemporary imaging modalities, however, the diagnosis of epiploic appendagitis need no longer hinge on the pathologic specimen but may be established by the emergency physician. As this disorder recently has been demonstrated to be predominantly self-limited, laparotomy no longer is considered necessary. Conservative management has been shown to be safe. The anatomy, pathophysiology, clinical presentation, radiologic evaluation, and emergency management of epiploic appendagitis are reviewed.     

Old and new infarction of an epiploic appendage: ultrasound mimicry of appendicitis

Epiploic appendagitis is a self-limiting disease. Depending on its location, it may simulate nearly any acute abdominal condition. The ultrasound and computed tomographic (CT) features are characteristic, enabling ready diagnosis and thus preventing an unnecessary laparotomy. We describe a patient with acute abdominal pain in the right lower quadrant, in whom the combination of an old and fresh infarction of an epiploic appendage simulated appendicitis on ultrasound. Subsequent CT examination made the correct diagnosis.     

Acute epiploic appendagitis mimicking symptoms of urinary tract infection: A diagnostic enigma in the emergency department

The epiploic appendages (also known as appendices epiploicae) are usually located on the anti‐mesenteric surface of the colon, extending from the caecum to the rectosigmoid, and epiploic appendagitis (EA) is the inflammation of these appendages. We report a clinical image of epiploic appendagitis creating a diagnostic challenge.     

A Mysterious Cause of a Surgical Abdomen

Background

Epiploic appendagitis is a rare cause of acute-onset abdominal pain. The severity of pain at presentation and the infrequency with which it is encountered make it a diagnostic challenge.

Objectives

To present a case report exemplifying a diagnostic challenge posed by acute-onset abdominal pain that eventually led to the diagnosis of epiploic appendagitis.

Case Report

A 50-year-old woman presented to the Emergency Department complaining of excruciating, sudden-onset lower abdominal pain. All routine laboratory investigations were within normal limits, as were an acute abdominal X-ray series. Computed tomography scan of the abdomen and pelvis with contrast showed a focal fatty infiltration in the left lower quadrant with fat-stranding towards the colon, representing the classical radiological presentation of epiploic appendagitis. The patient was admitted and successfully managed conservatively with intravenous fluids and ibuprofen. The patient made a full recovery and was discharged 3 days after admission.

Conclusions

Due to its benign, self-limited course, it is important to recognize this disease process to avoid unnecessary surgical and medical interventions. Epiploic appendagitis should be suspected in patients presenting with acute onset abdominal pain localized to the left lower quadrant or right lower quadrant with no associated systemic manifestations. Improvements in imaging technology have enabled confirmation of the diagnosis with non-invasive methods.     

Epiploic appendagitis in a 24-year-old woman

Epiploic appendagitis is a very rare condition that results from acute inflammation of an appendix epiploica. We report a case involving a 24-year-old woman who presented to the emergency department with abdominal pain localized to the left lower quadrant. The patient was diagnosed with epiploic appendagitis, which was confirmed through findings obtained from a contrast-study computed tomography of the abdomen. The patient was subsequently taken to the operating room for a diagnostic laparoscopy due to persistent pain. Necrotic epiploic appendagitis was found on the descending colon, which was removed laparoscopically.     

Epiploic appendagitis and omental infarction: pitfalls and look-alikes

Epiploic appendagitis and omental infarction are benign self-limiting conditions that are more frequent than generally assumed. Both disorders frequently mimic symptoms of an abdominal surgical emergency, often leading to clinical misdiagnosis of appendicitis or diverticulitis. Because a misdiagnosis can result in an unnecessary laparotomy, a correct diagnosis is of great importance. Ultrasound and computed tomography can be used to make a reliable diagnosis. This pictorial essay illustrates the various ultrasonographic and computed tomographic appearances of epiploic appendagitis and omental infarction and focuses on their radiologic differential diagnoses and pitfalls. Received: 22 February 2001/Accepted: 18 April 2001     

Epiploic appendagitis: adding to the differential of acute abdominal pain.

We report a patient with epiploic appendagitis who presented with acute abdominal pain. Emergency Department and discharge courses are described. The pathophysiology, presentation, diagnosis, and treatment of this disorder are discussed. Knowledge of this uncommonly diagnosed entity and its usual benign course may allow the Emergency Physician to order the appropriate studies to help avoid unnecessary surgical treatment.