儿童肠及肠系膜钝性创伤的CT诊断

目的：探讨CT检查对儿童急性肠及肠系膜钝性创伤的诊断价值。方法：分析11例经临床诊断或手术证实的儿童肠及肠系膜钝性创伤CT表现，全部病例均有明确的腹部外伤史，6例手术治疗，5例保守治疗。结果：11例患者中，胃损伤1例，十二指肠损伤3例，小肠及肠系膜损伤7例。CT表现有气腹、腹腔积液、肠壁肿胀、肠系膜模糊、肠管扩张等。在手术治疗的6例中，胃穿孔1例，小肠穿孔4例．肠壁血肿1例。结论：CT诊断肠及肠系膜急性钝性创伤明显优于X线平片和B超检查。不仅可清晰显示少量腹腔积气，估计腹腔积液、积血的量，显示实质脏器损伤，还可直接显示肠壁、肠系膜血肿，对外科医生确定治疗方案有重要意义。

CT diagnosis of bowel and mesentery blunt injury in children

Objective:To assess the value of CT in the diagnosis of acute bowel and mesentery blunt injury in children.Methods:The CT manifestation of 11 patients with acute bowel and mesentery blunt injury in children were analyzed.All cases had a history of apparent abdominal injury.6 patients underwent surgery and 6 were treated conservatively.Results:There was stomach injury 1 case,duodenum injury 3 cases,intestine or mesentery injury 7 cases.CT findings included intraperitoneal free air,intraperitoneal fluid collection,bowel wall or mesentery edema and bowel dilation.In the operated 6 cases,it was found stomach perforation 1 case,intestine perforation 4 cases and bowel hematoma 1 case.Conclusion:CT is superior to ultrasonography and X ray plain film in diagnosis of acute bowel and mesentery injury in children.CT not only can show intraperitoneal free air and fluid collection clearly and parenchymal organ injuries,but also can show bowel and mesentery hematoma.CT scan is very useful for surgeons in treatment planning.