外伤性肠穿孔的CT征象

目的:探讨CT对外伤性肠穿孔的诊断价值。材料与方法:对2002年7月至2006年1月在我院住院,并经手术证实的42例外伤性肠穿孔患者的CT图像进行回顾性分析。其中腹部钝挫伤27例,锐器伤15例。所有病例均未口服造影剂,也没有进行增强扫描。结果:穿孔发生在十二指肠5例,空肠12例,回肠9例,结肠18例,直肠1例。外伤性肠穿孔的CT征象包括:腹腔游离气体(20/42)、腹膜后游离气体(6/42)、肠壁增厚(21/42)、腹腔游离积液(25/42)、肠袢间(系膜)积液(5/42)、系膜浸润(19/42)、系膜血肿(4/42)及肠管扩张积液(4/42)等。结论:肠穿孔的CT所见均为间接征象,单一CT指征对外伤性肠穿孔的诊断价值有限,综合分析是提高诊断率的有效方法。

CT Findings of Traumatic Bowel Perforation

Purpose:To assess the value of computed tomography(CT) in the diagnosis of traumatic bowel perforation.Materials and Methods:Forty two cases of CT findings of traumatic bowel perforation,which were confirmed by operation from July 2002 to January 2006 in this hospital,were reviewed retrospectively.Twenty seven cases of blunt abdominal trauma and 15 cases of sharp abdominal trauma were identified.All patients were imaged without using of oral and intravenous contrast material.Results:Surgically confirmed bowel perforation occurred in the duodenum(5),jejunum(12),ileum(9),colon(18),and rectum(1).CT findings in traumatic bowel perforation include free intraperitoneal air(20/42),free retroperitonea air(6/42),bowel wall thickening(21/42),free intraperitoneal fluid(25/42),mesenteric fluid collections(5/42),mesenteric stranding(19/42),mesenteric hematoma(4/42)and bowel wall enlargement with fluid collections(4/42).Conclusion:CT findings of bowel injury are all indirect signs.No individual CT sign can be considered both sensitive and specific.Comprehensive analysis is an effective method for increasing the level of diagnosis for bowel injury.