腹股沟及其周围疝所致肠梗阻CT诊断

目的 探讨CT对腹股沟及其周围疝所致肠梗阻的诊断价值.资料与方法 回顾性分析17例经手术证实的腹股沟及其周围疝所致肠梗阻的CT表现,CT检查包括全腹部平扫、动脉期及门脉期增强.结果 17例患者均有不同程度的肠梗阻表现,腹股沟斜疝9例,CT表现为疝囊内肠管从腹壁下动脉外侧、腹股沟韧带前上方走行,行经腹股沟管内；直疝1例,CT表现为扩张的小肠肠管从腹壁下动脉内侧的直疝三角区(Hesselback三角)直接由后向前突出,疝囊不进入阴囊；股疝3例,CT表现为股疝疝囊位于股三角区、耻骨结节水平线以后、腹股沟韧带后下方；闭孔疝4例,CT表现为闭孔外肌与耻骨肌之间的肠管影和腹部肠管相连.结论 CT检查能明确诊断腹股沟及其周围疝所致肠梗阻.

CT Diagnosis of Intestinal Obstruction Caused by Hernias in Inguinal Canal and Adjacent Areas

Purpose To evaluate the diagnostic value of intestinal obstruction caused by hernias of CT.Materials and Methods CT features of 17 cases with intestinal obstruction caused by hernias in inguinal canal and adjacent areas confirmed by surgery were retrospectively analyzed.All 17 cases underwent abdominal plain,arterial phase and portal phase CT scan.Results All 17 cases demonstrated different degrees of obstruction.In 9 cases with inguinal hernia,CT showed bowel in the hernia sac located lateral to inferior epigastric artery and anterior to the inguinal ligament,passing the inguinal canal.In 1 case with direct hernia,dilated bowel loops protruding anteriorly through Hesselback triangle medial to the inferior epigastric artery without entering the scrotal sac.In 3 cases with femoral hernia,CT showed hernia sac located in femoral triangle and posterior to the pubic tubercle,below the inguinal ligament.In 4 cases with obturator hernia,CT showed bowel loops between obturator externus and pubic muscle,connecting to intra-abdominal bowel.Conclusion CT is able to diagnose intestinal obstruction caused by hernia in inguinal canal and adjacent areas.