不同病因所致化脓性腹膜炎的CT表现特征

目的 探讨不同病因所致继发性化脓性腹膜炎(SPP)的CT表现特征。资料与方法 搜集32例有CT检查资料的SPP病例，其中经手术病理证实24例，经腹腔穿刺和／或其他临床综合指标诊断8例。着重观察引起SPP的原发病灶及腹膜炎的CT表现。结果 32例除均具有SPP的CT表现外，它们的原发病灶的CT征象显示如下：无腹部手术史的25例腹膜炎中，胃肠道穿孔10例，急性阑尾炎7例，急性胆囊炎3例，腹、盆腔脓肿3例，升结肠炎症伴周围炎症2例；有腹部手术史的7例腹膜炎中，脓肿形成5例，引起腹腔感染2例。结论 应用CT扫描诊断SPP，有利于显示SPP原发病灶及腹膜炎CT征象以及二者的解剖关联性，对临床表现不典型病例的诊断和鉴别诊断有较大价值。

CT Features of Pyogenic Peritonitis Caused by Different Etiological Factors

Objective To investigate the CT features of the secondary pyogenic peritonitis (SPP) caused by different etiological factors.Materials and Methods 32 patients with SPP were underwent the spiral CT scan, of which 24 cases were proven by surgery and pathology and 8 cases were proven by clinical findings. Emphasis was placed on CT features of the primary lesions and their secondary changes involving the peritoneum. Results The signs of primary lesions of SPP were revealed as follows: among the 25 without abdominal operation history cases, the perforation of gastrointestinal tract 10 cases; acute appendicitis 7 cases; acute cholecystitis 3 cases; abdominal and pelvic cavity abscesses 3 cases; colitis with phlegmon 2 cases. Among the 7 postoperative cases, abscesses 5 cases; infections in peritoneal cavity 2 cases.Conclusion The CT scan is valuable for revealing the CT features and anatomic relevance consisting of both the primary lesions and the secondary changes involving the peritoneum in SPP, the CT scan is convenient to make diagnosis and differential diagnosis towardw atypical cases.