老年人食管裂孔疝的影像学诊断

目的 探讨老年人食管裂孔疝的影像学特点。方法 搜集自1999年7月至2004年7月经常规胸片、胃肠钡餐或CT诊断为食管裂孔疝的老年患者共22例，分析食管裂孔疝在三种检查方法上的影像表现。结果 胸片检查22例。确诊7例(31．8％)：钡餐检查14例，阳性13例(92．8％)；CT检查11例，均为阳性(100％)。可复性食管裂孔疝10例(45．5％)，不可复性12例(54．5％)；后者包括短食管型5例，食管旁疝2例，混合型5例。结论 老年人食管裂孔疝的临床表现多种多样，并发症多，常易误诊．胸片对不可复性食管裂孔疝有相当高的检出率；消化道钡餐检查诊断分型准确，阳性率高。应作为本病首选检查方法：CT可作为可疑病例较好的补充检查方法。

Image diagnosis of hiatus hernia in the elders

Purpose To probe the imaging features of hiatus hernia in the elderly. Methods 22 cases of patients with suspected hiatus hernia were studied with chest film, barium meal of alimentary canal and CT respectively. Results The positive rate were 31.8% (n=6 cases) in chest film, 92.8% (n=14 cases) in barium meal of alimentary canal and 100% (n=ll cases) in CT. 10 cases were reducible hiatus hemia, and others were non-reducible including short esophagus type(n=5 cases), paraesophageal hernia type(n=2 cases) and mixed type(n=5 cases). Conclusion There is a high positive rate in chest film for diagnosing the non-reducible hiatus hemia. Barium meal of alimentary canal should be the best method for diagnosing hiatus hernia because of its accurate typing and high positive rate, and CT play an additional role for the suspected hiatus hernia.