摘要
目的探讨明确回盲部解剖在提高超声诊断急性阑尾炎中的价值。方法对我院经手术、病理或临床诊断证实的46例急性阑尾炎病人进行术前超声诊断、术后回顾分析。结果从解剖位置看,阑尾多数为回肠前位(18例)、盲肠内位(10例)及盲肠后位(8例),4例为回肠下位,3例为异位阑尾。3例因肠气干扰未检出,超声诊断正确率为93%。46例腹痛患者中,6例单纯性阑尾炎超声下仅见阑尾轻度肿大(直径6-8mm)。24例化脓性阑尾炎表现为阑尾明显肿大(直径9-15mm),伴腔内液性回声。13例为坏疽性阑尾炎,表现为阑尾明显肿大伴阑尾周围片状不规则高回声,并伴周围或盆腔积液。3例超声未能检出的病例中,2例术后证实为盲肠后位单纯性阑尾炎及盲肠后位化脓性阑尾炎,1例术后证实为回肠后位单纯性阑尾炎。结论认识回盲部解剖,了解阑尾的变异情况及病理分级对于增加诊断符合率及减少漏诊有重要意义。
Objective To explore the value of cognizing ileocecal anatomy in ultrasonic diagnosis of acute appendicitis. Methods The uhrasonography, pathology, surgery and clinical manifestation of 46 patients diagnosed as acute appendicitis in our hospital were analyzed, retrospectively. Results According to the anatomical position,appendices were mainly detected in preileal position in 18 cases, midinguinal position in 10 cases and retrocecal position in 8 cases, pelvic position in 4 cases,and ectopic appendix was found in 3 cases. Three cases were missed by the disturbance of bowel air. The accurate rate of ultrasound diagnostic rate was 93%. Among 46 cases of abdominal pain, 6 cases of purely acute appendicitis showed lightly enlarged appendices （ diameter 6 - 8 mm） by ultrasonography; 24 cases of suppurative appendicitis manifested as obviously enlarged （diameter 9 - 15 ram）with intracavitary echo pattern;13 cases of gangrenous appendicitis showed enlarged appendices with periphery lamellar irregular hyperechogenicity and periphery or pelvic fluid ;3 cases were not detected by ultrasound, of which,2 cases were proved by surgery as acute retrocecal appendicitis and retrocecal appendicitis,and 1 case was acute retroileal appendicitis. Conclusion To cognize ileocecal anatomy and to know the variation of the appendix and pathology are of great importance for improving the diagnosis accordance rate and reducing the missed diagnosis of acute appendicitis.
出处
《山西医科大学学报》
CAS
2009年第1期75-77,共3页
Journal of Shanxi Medical University
关键词
急性阑尾炎
超声检查
解剖
acute appendicitis
ultrasonography
anatomy
