胆石性肠梗阻的CT诊断

目的:评价CT对胆石性肠梗阻的诊断价值。方法:回顾性分析5例经手术证实的胆石性肠梗阻患者的CT检查资料及临床表现。结果:所有病例CT表现均见肠腔内异位结石、肠梗阻、胆系积气及胆囊窝结构紊乱,1例显示腹腔游离积液,1例结石位于十二指肠降段,1例结石位于空肠,另3例结石位于回肠。结石呈圆形或椭圆形,直径2.5~5cm,梗阻以上肠管扩张,可见气液平,1例完全性肠梗阻病例梗阻以下肠管空虚。5例术前CT诊断准确率为100%。结论:胆石性肠梗阻有典型的CT表现,CT是胆石性肠梗阻的最佳方法。

CT diagnosis of gallstone ileus

Objective:To evaluate the clinical application of CT in the diagnosis of gallstone ileus.Methods:The image findings of 5 patients with gallstone ileus comfirmed by surgical findings were reviewed retrospectively.Results:The follow findings were searched on all cases: ectopic stones,signs of ileus ,gallbladder region gas.Peritoneal fluid was seen in 1 case.The ectopic stones were wedged in the descendant duodenum(n=1),jejunum(n=1),ileum(n=3),the calculus diameters were from 2.5cm to 5cm.Dilated proximal small bowel loops with multiple air-fluid levels could be seen above the obstruction location,collapsed distal bowel could be seen in 1 case of complete obstruction.The diagnostic rate of CT preoperatively to gallstone ileus was 100%.Conclusion:The appearance of gallstone ileus was particulary striking,CT is the best valuable tool for the diagnosis of gallstone ileus.