闭孔疝合并肠梗阻的多层螺旋CT表现及诊断价值

目的分析闭孔疝合并肠梗阻的多层螺旋CT表现及多层螺旋CT诊断价值。方法以我院2012年1月-2015年6月经手术病理证实的15例闭孔疝合并肠梗阻患者为研究对象,对其术前多层螺旋CT(MSCT)影像学表现进行回顾性分析。结果术前MSCT检查提示小肠梗阻,表现为小肠扩张积气,直径3cm以上;梗阻区域表现出典型鸟嘴征,闭膜管区疝囊颈小结节状,疝囊于闭孔外肌与耻骨肌间嵌顿;小肠缺血坏死8例,CT上表现出小肠肠壁增厚且水肿,肠系膜脂肪间隙模糊,伴少量腹水,穿孔4例,表现为腹腔内少量游离气体可见。结论闭孔疝合并肠梗阻MSCT影像特征典型,其鸟嘴状等直接征象能明显提高疾病术前诊断准确率,为手术提供重要影像依据。

The Findings and Diagnostic Value of Multi-Slice Spiral CT in Obturator Hernia with Intestinal Obstruction

Objective To analyze the findings and diagnostic value of multi-slice spiral CT in obturator hernia with intestinal obstruction.Methods 15 cases of patients with obturator hernia and intestinal obstruction surgically and pathologically confirmed in our hospital from January 2012 to June 2015 were taken as the research objects. The imaging findings of preoperative multi-slice spiral CT (MSCT) were retrospectively analyzed.Results Preoperative MSCT examination showed small intestine obstruction, which manifested as expansion and pneumatosis of small intestine, 3cm or longer in diameter; Obstruction regions showed a typical beak sign, nodular hernia sac neck in obturator canal region, incarceration of hernial sac between external obturator muscle and pectineus; There were 8 cases of small intestinal ischemia and necrosis, showing samll intestinal wall thickening and edema on CT, fuzzy mesenteric fat clearance, with a small amount of ascites. There were 4 cases of perforation, showing visible small amount of free gas in the abdominal cavity.Conclusion The MSCT characteristics of obturator hernia with intestinal obstruction are typical. Its beak like and other direct signs can obviously omprove the preoperative diagnostic accuracy of the disease and provide important imaging evidence for the operation.