单纯腹腔网膜脂肪突入食管裂孔上消化道造影表现

目的：探讨单纯腹腔网膜脂肪(PAOF)突入食管裂孔(EH)的上消化道造影(GI)表现。方法收集7例 GI和 MSCT检查发现PAOF突入 EH 患者影像资料,分析 GI表现并与 MSCT对照。结果4例食管下段周围伴较大软组织影,密度浅淡,黏膜相显示食管下段2~4 cm黏膜粗乱,其中1例食管与软组织上缘交界处黏膜线被牵拉吊起；充盈相显示管腔轻度狭窄,管壁软,病变上界可见。3例 His角圆钝,其中1例显示 His角随体位变化。4例 MSCT显示食管下段右旁较大囊状脂肪密度影。3例 GI表现基本正常,其中1例食管膈壶腹持久,MSCT显示食管下段右旁较小囊状脂肪密度影。7例 MSCT多平面重建(MPR)均显示囊状脂肪密度影下部与腹腔脂肪相连,胃左动脉弓状指向或突入 EH。结论食管下段伴较大而密度浅淡软组织影、黏膜和管腔改变轻、病变上缘有分界及 His角圆钝可变为PAOF突入 EH 的 GI特殊表现。

The upper gastrointestinal imaging performance of herniation of pure abdominal omental fat into esophageal hiatus

Objective To investigate the gastrointestinal imaging (GI)performance of herniation of pure abdominal omental fat (PAOF)into the esophagus hiatus(EH).Methods 7 cases of PAOF herniated into EH found by GI and MSCT were collected.The performance of GI was analyzed and compared with MSCT.Results 4 cases with large soft tissue shadow around lower segment esophagus,its density are lower,esophageal mucosa was showed coarse disorderly in the range of 2-4 cm of lower segment esophageal in the mucous membrane phase,of which 1 case with the mucosal line of esophagus at the j unction of esophagus and the superior border of the soft tissue slung up.Mild stenosis lumen of flexible wall was displayed in the filling phase,the upper bound of the lesions was often visible.3 cases with obtuse His angle,of which 1 case its change was shown with position.A more larger cystic fat density shadow was showed in MSCT right side of lower segment esophagus.3 cases were almost normal GI performance,among them 1 case of esophageal diaphragmatic ampulla lasting and a smaller cystic fat density shadow was showed in MSCT right side lower segment esophagus.The connection of the lower part of cystic fat density shadow to abdominal fat was showed all in 7 cases by MSCT MPR,and left gastric artery was shown to point to or protruded into EH by arcuate form.Conclusion A slight change of mucous membrane and lumen of lower segment esophagus which bounded above with larger and fade soft tissue density shadow and His angle obtuse variable were the special GI performance of the herniation of PAOF into EH,and the diagnose depended on MSCT.