医源性肠外瘘的分型和CT表现

目的:探讨医源性肠外瘘的分型和CT表现.方法:对754例医源性肠外瘘实施了CT检查.参照临床分型,将肠外瘘分为管状瘘、唇状瘘和断端瘘三个类型,并分析其CT征象.结果:管状瘘所占比例最高(占68.70%),表现为内、外口之间不均匀的管道形成;唇状瘘(占31.30%)的CT征象特点是较大的外口,呈唇状改变,无瘘管形成.管状瘘的腹腔和腹膜后脓肿发生率明显高于唇状瘘(P＜0.01),而唇状瘘的肠壁炎性改变发生率较高(P＜0.01).结论:CT检查能够显示医源性肠外瘘的临床分型,对治疗具有指导性作用.

Classification and CT Appearances of Iatrogenic Enterocutaneous Fistulae

Objective:To discuss the classification of iatrogenic enterocutaneous fistulae and their relative CT appearances.Methods:Computed tomography (CT) was performed in 754 patients with iatrogenic enterocutaneous fistulae.Clinically,enterocutaneous fistulae were classified as three types:ductal fistulae,labral fistulae and disconnecting fistulae.Their relative CT appearances were retrospectively reviewed.Results:The incidence rate of the ductal fistulae was the highest,accounting for 68.70% of the cases.There was an irregular channel communicating the internal opening and its external counterpart in a ductal fistula.The characteristic sign of the labral fistula,accounting for 31.30% of the cases,was the one without a "fistula",however,with a considerably large external opening and its labrum-like rims.The occurrence rate of intra-abdominal and retroperitoneal abscesses was significantly higher in the cases of ductal fistulae than that in labral fistulae (P<0.01),while the inflammatory involvements of the intestinal walls were more frequently seen in the cases with labral fistulae than those with ductal fistulae (P<0.01).Conclusion:CT features were able to demonstrate and help the clinical classification of iatrogenic enterocutaneous fisrulae and further assist the selection of appropriate clinical treatments as well.