闭合性腹部外伤致胰腺损伤的CT诊断(附15例报告)

目的:评价CT对闭合性腹部外伤所致胰腺损伤的临床诊断价值。方法:回顾性分析15例经手术证实的闭合性腹部外伤所致胰腺损伤的CT征象。结果:15例闭合性腹部外伤所致胰腺损伤中,胰腺挫伤5例,胰腺完全性断裂6例,胰腺不完全性断裂1例,胰腺出血3例。胰腺内出血、水肿,胰腺增粗是胰腺挫伤的直接征象;胰腺外形不连续、平扫或增强时垂直胰腺长轴的低密度、线条状影是胰腺断裂的直接征象。胰周积液、网膜囊积血积液,肾前筋膜增厚,腹腔积液是胰腺损伤的间接征象。结论:CT检查对胰腺损伤的诊断价值较大,CT增强比平扫更能明确胰腺的断裂;CT检查对于主胰管的断裂的诊断价值有待进一步研究。

CT diagnosis of pancreatic injury induced by blunt abdominal trauma (analysis of 15 cases)

Objective:To evaluate the clinical value of CT by analyzing the CT manifestations of the pancreatic injury induced by blunt abdominal trauma.Methods:The CT findings of 15 patients with surgical proved pancreatic injury induced by blunt abdominal trauma were reviewed retrospectively.Results:In our 15 patients, there were 5 patients with pancreatic contusion,6 cases with pancreas broken completely,1 case with pancrease broken incompletely and 3 cases with hemorrhage were also found.The direct CT signs of pancreatic contusion were hemorrhage,edema and thickening of pancreas;and the broken of pancreas shape,lower density line across the pancreas vertically on pre-and post-CT imaging were the direct signs of pancreas broken.The indirect CT signs of pancreatic contusion included peripancreatic effusion,hematocele and effusion of omental bursa,prerenal fascia thickening and effusion of abdominal cavity.Conclusion:The diagnostic value of the CT imaging is demonstrated for pancreatic injury,and broken pancreatic could be confirmed with contrast-enhanced CT better than non-enhanced CT.There is no diagnostic value with CT to make sure whether main pancreatic duct broken or not.