摘要
目的探讨警卫肠袢在急腹症影像学诊断中的价值。方法收集一组我院121例经临床或手术病理诊断明确的急腹症患者的临床及影像学资料,对其腹部平片及CT资料进行回顾性分析。结果 121例患者中行立卧位腹部平片检查121例,提示阳性诊断97例,显示警卫肠袢68例;其中行腹部CT检查48例,阳性诊断48例,显示警卫肠袢24例。游离气腹10例,其中阑尾炎穿孔并显示警卫肠袢2例;22例肠梗阻中早期小肠梗阻3例,显示为警卫肠袢样改变2例;急性胆囊炎20例,显示为右上腹部警卫肠袢13例;急性胰腺炎15例,显示为中腹部警卫肠袢11例;急性阑尾炎42例,显示为右下腹部警卫肠袢34例;泌尿系结石12例,显示为中腹部警卫肠袢4例,显示为下腹部警卫肠袢1例;乙状结肠憩室炎2例,显示为右下腹部警卫肠袢1例。结论警卫肠袢是急腹症影像学检查中一个非常有用的征象,特别在非穿孔及非梗阻的急性腹痛患者中能根据其在立卧位腹部平片上出现的部位对病因做出较好的提示作用;立卧位腹部平片对急腹症所致警卫肠袢的显示稍优于腹部CT,但腹部CT可准确显示表现或不表现为警卫肠袢的急腹症的病因。
Objective To analyze the value of “sentinel loops” in the diagnosis of acute abdominal pain .Methods 121 ca-ses of acute abdominal pain with defined diagnosis by pathology and /or following-up clinically were collected in our hospital , whose clinical and imaging data （ the abdominal plain film and CT data ） were analyzed retrospectively .Results Out of all 121 patients with acute abdomen , 121 cases presented with erect and supine abdominal plain film , and 97 cases with positive X-ray finding to suggest the diagnosis , 68 cases with the sign of sentinel loops , 48 cases with abdominal CT scan , in which all of 48 ca-ses to make the right diagnosis , 24 cases with the sign of sentinel loops .Free pneumoperitoneum were found in 10 cases, inclu-ding 2 cases of appendicitis perforation with the sign of sentinel loops .Out of 22 cases of small intestinal obstruction , 2 cases presented with the sign of sentinel loops in 3 cases of early phase of small intestinal obstruction .Out of 20 cases of acute cholecys-titis, 13 cases showed the sentinel loops in right upper abdomen .Out of 15 cases of acute pancreatitis , 11 cases showed sentinel loops in in middle abdomen .Out of 42 cases of acute appendicitis , 34 cases showed the sentinel loops in right lower abdomen . Out of 12 cases of urinary calculi , 4 cases showed the sentinel loops in middle abdomen and 1 case in the lower abdomen .Out of 2 cases Sigmoid colon diverticulitis , 1 case showed sentinel loops in left lower abdomen .Conclusion The sign of ＂sentinel loops＂is a very useful signs of acute abdomen imaging examination .According to its position , the sentinel loops in the abdominal plain film can play a good role to suggest the diagnosis of the acute abdominal pain , especially in inflammation patients with acute abdominal pain .It is slightly better to show the sign of ＂sentinel loops” on abdominal plain film than on abdominal CT , but ab-dominal CT can show accurately the etiology of acute abdominal pain .
出处
《医学影像学杂志》
2016年第3期477-480,共4页
Journal of Medical Imaging
关键词
急腹症
警卫肠袢
体层摄影术
X线计算机
Acute abdominal pain
Sentinel loops
Tomography,X-ray computed
