床旁X线摄片对新生儿坏死性小肠结肠炎的诊断价值

目的：探讨床旁X线摄片对新生儿坏死性小肠结肠炎（NEC）的诊断价值。方法：回顾性分析57例经临床确诊NEC的患儿的床旁腹部X线征象和临床表现。结果：57例NEC患儿Ⅰ期15例、Ⅱ期22例、Ⅲ20例,均进行了1次或1次以上床旁X线摄片,X线影像示肠管扩张积气48例,肠管形态欠规则、肠间隙增宽39例,肠梗阻11例,肠壁积气21例,门静脉积气8例,腹腔游离气体18例。早产儿47例,极低体重儿（体重低于1500g）18例,行腹腔镜或剖腹探查并置管引流者29例,仅腹腔穿刺引流者7例。结论：床旁X线影像足以诊断NEC,并且摄片方便、高效,有助于随时评估新生儿腹部肠管情况。     

小儿急性假性肠梗阻的临床与影像分析

目的 增强对小儿急性假性肠梗阻的临床表现与影像学特点的认识,提高诊断与鉴别诊断能力。方法 回顾性分析经临床证实的56例小儿急性假性肠梗阻的腹部X射线平片表现和临床资料。结果 56例患儿均有不同程度、不同类型的原发病,其中支气管炎25例,支气管肺炎11例,上呼吸道感染13例,婴幼儿腹泻7例。X射线改变:显示肠胀气改变18例;肠管扩张,积气较多及多个小气液平影20例;肠管明显扩张,有多个气液平影18例。本组56例经过儿外科住院保守治疗后,临床症状明显好转,直至消失,38例有气液平影的患儿复查腹平片时,梗阻征象全部消失。结论 部分小儿急性假性肠梗阻患儿腹部平片可出现类似机械性肠梗阻的征象,二者应注意鉴别,临床治疗时应注意临床与影像的密切结合。     

10例胆石性肠梗阻的影像学分析

目的：总结分析10例胆石性肠梗阻患者的影像学表现,以探讨影像学手段在诊断胆石性肠梗阻中的价值。方法：对本院5年来收治已经临床证实的10例胆石性肠梗阻患者的影像资料进行回顾性分析。结果：病例均具有较为典型的X线平片及B超特征,但以CT表现最为典型,几乎所有患者CT检查均可见肠梗阻征象、肠内异位结石、胆囊及胆系积气,多数患者可见十二指肠与胆囊分界不清,少数患者则可显示胆肠瘘。结论：影像学检查对胆石性肠梗阻具有较好的辅助诊断作用,X线平片和B超检查可作为CT诊断的筛查手段,而CT诊断则可为胆石性肠梗阻的诊断提供最为丰富的诊断信息。     

腹部X线平片与CT诊断肠梗阻的临床效果观察

目的了解腹部x线平片与CT诊断肠梗阻的临床价值。方法回顾性分析我院2012年3月至2014年3月收治的74例肠梗阻患者的临床资料,分别进行腹部x线平片检查及CT检查,观察两种检查方法的准确性。结果CT检查在明确肠梗阻发生部位、病因等方面优于腹部x线平片检查,且在患者舒适度、操作难度、图像清晰度等方面明显优于腹部x线平片检查,差异具有显著统计学意义（P〈0．05）。结论CT检查对肠梗阻诊断的准确率优于腹部x线平片检查,值得临床广泛推广与应用。     

新生儿坏死性小肠结肠炎的床旁DR诊断

目的：探讨新生儿坏死性小肠结肠炎床旁DR腹平片的表现,提高认识,以便更好诊断该疾病,帮助临床判断病情进展及转归。方法：收集我院2012年5月-2014年5月经床旁DR及临床确诊病例13例,对相应DR腹平片表现进行回顾性分析。结果：首次摄片考虑本病12例,经临床观察,间隔6-24h复查,考虑本病1例。13例中,男8例,女5例。年龄2-21d,平均8d,10例早产儿。腹部X线片早期表现为不完全性小肠梗阻征象,肠管排列紊乱,肠管扩张4例;典型表现为局限性壁内积气为5例;晚期表现为胃肠壁内广泛积气1例;3例合并少量气腹。所有病例未见门静脉积气。结论：床旁DR腹平片在新生儿坏死性小肠结肠炎的诊断,以及判断病情的进展、转归中有重要价值。但是新生儿坏死性小肠结肠炎早期X线表现不明显、不典型,容易误诊、漏诊,若临床怀疑NEC,X线检查一定要全面细致,以早期诊断、正确判断病情。     

X线与超声联合诊断在抗精神病药物致麻痹性肠梗阻中的应用

目的 探讨X线与超声联合诊断在抗精神病药物致麻痹性肠梗阻中的应用.方法 回顾性分析124例抗精神病药物致麻痹性肠梗阻患者的X线和超声检查资料,分析其影像学表现和诊断符合率.124例均行立位腹部X线平片和透视检查,其中68例同时行B超检查.结果 X线诊断符合率为87.9%(68/68),漏诊率为12.1%(15/124);超声诊断符合率为82.4%(56/68),漏诊率为17.6%(12/68);两者诊断符合率和漏诊率比较差异无统计学意义(P＞0.05).X线联合超声检查的诊断符合率为100.0%(68/68),无一例漏诊,与单独应用X线及超声检查诊断符合率及漏诊率比较差异有统计学意义(P＜0.05).结论 X线检查是诊断抗精神病药物致麻痹性肠梗阻的首选方法,超声检查对肠腔积液的发现具有优越性,两者结合能够提高诊断符合率.     

抗精神病药物致麻痹性肠梗阻的X线与超声诊断价值探讨

目的研究探讨对于抗精神病药物导致的麻痹性肠梗阻关于X线和超声进行诊断的临床价值。方法选择2010年1月—2013年1月,经确诊是由于抗精神病药物导致的麻痹性肠梗阻患者82例。随机平均分为2组,每组41例,记为X线组和超声组。对X线组行X线腹部平片和透视检查。B超组行B超检查。比较两组检查方式的诊断符合率以及诊断表现情况。计数资料采用χ2检验,P<0.05为差异有统计学意义。结果 X线组检出34例。漏诊7例。诊断符合率82.9%。而超声组检出32例。漏诊9例,诊断符合率78.0%。两组相比诊断符合率相当,差异无统计学意义(P>0.05)。结论 X线检查是临床上对抗精神病的药物所导致的麻痹性肠梗阻诊断的首选方法。而超声则对发现患者肠腔积液有着明显的优越性。将两者结合起来检查可以提高临床诊断的符合率。     

多层螺旋CT在胆石性肠梗阻诊断中的价值

目的探讨多层螺旋CT在胆石性肠梗阻诊断中的价值。方法随机选取经过临床证实患有胆石性肠梗阻的患者16例,并对其临床资料进行分析。所有患者均接受了腹部超声和X先腹部平片以及CT平扫检查。结果 16例患者多层螺旋CT均表现出胆石性肠梗阻征象。多层螺旋CT有100%的临床诊断准确率。结论多层螺旋CT对胆石性肠梗阻诊断中有极其重要的价值。     

小肠梗阻影像诊断分析

目的探讨不同影像检查对小肠梗阻的诊断价值。方法对26例疑诊小肠梗阻患者,均行腹部CT平扫,口服76%泛影脯胺100ml行小肠造影检查。结果小肠造影检查提示不全肠梗阻16例,肠梗阻5例。CT显示小肠梗阻15例,肠腔积气积液11例。结论口服泛影脯胺造影检查对临床难以确诊的肠梗阻患者能提供影像依据,尤其对诊断不全性肠梗阻具有优越性,CT对诊断不全性小肠梗阻的困难,对发现小肠梗阻病因具有一定优势。     

36例超声和腹部X射线平片在诊断儿童急性肠梗阻中应用比较分析

目的探讨儿童急性肠梗阻实施超声和腹部X射线平片诊断的效果。方法取2016年1月~2017年1月间本院收治的36例儿童急性肠梗阻患儿进行研究,所有患儿均采取手术治疗确诊,对所有患儿术前均采取超声和腹部X射线平片检查,统计分析两种检测方式的诊断效果。结果患儿实施超声检查对儿童急性肠梗阻的检测准确率与腹部X射线平片检查相比明显较高,患儿实施超声检查对梗阻原因、梗阻部位、肠绞窄检测准确性与腹部X射线平片检查相比明显较高,差异具备统计学意义(P﹤0.05)。结论儿童急性肠梗阻实施超声诊断效果优于腹部X射线平片诊断。     

腹部手术后并发麻痹性肠梗阻的临床观察和护理

目的探讨腹部手术后麻痹性肠梗阻的临床观察和护理。方法对腹部手术后发生麻痹性肠梗阻30例进行分析。结果表明麻痹性肠梗阻多发生于术后3~5 d,经术后加强病情观察和积极采取治疗护理措施,其中26例在1~2 d肠麻痹解除,肠功能恢复,腹胀消失,肛门排气。4例在4~5 d肠功能恢复。结论充分做好术前准备,术后加强病情观察和有效的护理措施,促进肠功能恢复,可防治术后麻痹性肠梗阻的发生。     

Diagnostic image (356). A man with a painfully distended abdomen and a mass on the plain abdominal radiograph

A 44-year-old man had abdominal pain, abdominal swelling and constipation. A plain abdominal radiograph showed signs of an ileus and as an unrelated finding an extensively calcified former renal transplant.     

The ‘Third Revolution’

The paralytic ileus, poor nutritional state, and related complications that often develop following serious abdominal surgery have traditionally been accepted as unavoidable. Now, a nasogastric decompression and feeding tube is available that usually prevents paralytic ileus and also provides a complete liquid diet starting immediately after the operation, thus speeding wound healing and recovery.     

Gallstone ileus with two separate biliary-enteric fistulae

A patient with gallstone ileus associated with two separate biliary-enteric fistulae has been reported. The patient had exploratory laparotomy with removal of the gallstone from the distal ileum, repair of the two fistula tracts, and cholecystectomy. The pathology report showed adenocarcinoma of the gallbladder. The patient was discharged 14 days after surgery. It is important to point out that the diagnosis was not suspected prior to surgery, although the patient was elderly with known cholelithiasis, no prior abdominal surgery, and clinical symptoms of bowel obstruction. The plain abdominal film showed a partial small bowel obstruction pattern with a pair of air-fluid levels in the right upper quadrant, no air in the biliary tract, and no visible calculus. When there is a clinical suspicion of gallstone ileus and the plain abdominal film is not diagnostic, there are several modalities available that have been proven to be useful (ie, contrast medium examinations, ultrasound, and hepatobiliary scan).     

Diagnostic image (291). A man with a distended abdomen

A 52-year-old mentally retarded man with abdominal distension had a volvulus of the sigmoid, with a 'bird beak' sign on a plain abdominal radiograph.     

Methamphetamine-Induced Paralytic Ileus

Methamphetamine abuse has become a significant problem in the United States with recent surveys reporting that nearly 10 million Americans have tried methamphetamine at least once. Methamphetamine is a stimulant drug that causes the release of monoamine neurotransmitters. Among its most deleterious effects are its ability to produce tachycardia, hypertension, and ischemia. However, it also has the potential to cause clinically significant effects outside of the cardiovascular system although a case of paralytic ileus caused by methamphetamine use has not been described before in the literature. Described is a case in which a patient presented with chest and abdominal pain after methamphetamine use. The patient was ultimately diagnosed with a methamphetamine-induced paralytic ileus.     

输尿管镜气压弹道碎石术治疗体外冲击波碎石失败输尿管膀胱壁段结石126例

目的探讨应用体外冲击波碎石（ESWL）失败的输尿管膀胱壁段结石患者应用输尿管镜气压弹道碎石术（URS＋PL）治疗的临床疗效。方法对收治的126例采用URS＋PL治疗ESWL失败的输尿管膀胱壁段结石患者的临床资料进行回顾性分析。结果术后经复查腹部平片及静脉肾盂造影检查显示,手术取石共成功110例,成功率为87．30％;而在手术后2个月复查腹部平片及静脉肾盂造影显示结石排净者118例,成功率为93．65％。所有126例患者在为期6个月的随访过程中,失访48例,成功完成随访78例,所有接受随访的患者均未出现手术后并发症。结论URS＋PL治疗ESWL失败的输尿管膀胱壁段结石效果显著,并发症发哇率低．     

The abdominal radiograph: a pictorial review

The plain abdominal radiograph is one of the most frequently requested X-ray examinations by junior surgical and accident and emergency staff. Interpretation is often difficult, but this review outlines normal appearances, suggests a strategy for evaluation, and covers the common pathological appearances seen in hospital practice.     

Diagnostic modalities in diagnosis of adult patients with acute abdominal pain

In order to provide an accurate diagnosis and management strategy for adult patients with acute abdominal pain and peritoneal irritation, it is important to understand the value of various forms of diagnostics modalities. History, physical examination and laboratory results can generally differentiate between an acutely serious and a less serious abdominal problem. Patients with acute abdominal pain and no increase in either the leukocyte count or the concentration of C-reactive protein should be re-evaluated after 12 hours. If laboratory values are increased, then diagnostic imaging is necessary. For patients with diffuse abdominal pain and for patients with signs of shock or respiratory insufficiency, a CT-scan is the imaging method of choice. If symptoms are located in the left upper quadrant, an upright chest radiograph or a plain abdominal film are recommended. If symptoms are located in the right upper quadrant, ultrasonography will be preferred. If the diagnosis is still uncertain, a CT-scan will be performed. A CT-scan is indicated for lower abdominal pain in women with increased inflammatory parameters and in men aged 50 years or older with increased inflammatory parameters. If the cause of the abdominal pain is still unclear following a CT-scan, then diagnostic laparoscopy may be considered for fertile women of childbearing age and for men aged less than 50 years with signs of appendicitis.